Effectiveness of titanium plate usage in laminoplasty

Abstract

Background: Laminoplasty is an established technique for the treatment of cervical stenosis. However, the usage of plates to maintain patency of the laminoplasty door has not been well reported. This study plans to compare the clinical outcomes of laminoplasty with the usage of Sofamor-Danek laminoplasty plates versus techniques without plate usage. Materials and Methods: This study conducted a 2-year medical record review of all patients with multilevel cervical myelopathy who were treated with laminoplasty at UCLA or Cedars-Sinai medical center. Of 46 patients 18 had sufficient documentation to assess clinical outcome, 11 of which had placement of laminoplasty plates. Clinical outcomes were assessed using Odom's scoring criteria. Results: Blood loss and hospital stay are decreased with plate usage during laminoplasty. Average Estimated Blood Loss (EBL) was 160 cc with plate and 380 cc without. Hospital stay was 4.8 days with plate and 5.6 days without. There were no complications during any of the laminoplasty procedures regardless of instrumentation. All patients demonstrated improvement in symptoms after laminoplasty, with 73% of patients in the plate cohort having Odom Scores of “Excellent” versus 44% in the nonplate group. All patients, regardless of technique, showed improvement in symptoms. Conclusions: Laminoplasty with plate utilization is an effective treatment for cervical myelopathy. The similarity in outcomes and complications between these two similar cohorts suggests plate usage in laminoplasty is an attractive alternative to other methods. We hope that future efforts will continue to demonstrate the effectiveness and perhaps superiority of plate utilization in laminoplasty.

Keywords

• Laminoplasty
• titanium plate
• cervical myelopathy
• ossification of the posterior longitudinal ligament
• cervical spondylosis