Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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A Comparison of Implants Used in Double Door Laminoplasty : Allogeneic Bone Spacer versus Hydroxyapatite Spacer

  • Lee, Dong Yoon (Department of Neurosurgery, Keimyung University, School of Medicine, Dongsan Medical Center) ;
  • Lee, Chang Kyu (Department of Neurosurgery, Keimyung University, School of Medicine, Dongsan Medical Center) ;
  • Kim, In-Soo (Department of Neurosurgery, Keimyung University, School of Medicine, Dongsan Medical Center)
  • Received : 2016.05.25
  • Accepted : 2016.09.22
  • Published : 2016.11.01
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Abstract

Objective : The aim of this study was to compare the clinical and radiological outcomes associated with the use of hydroxyapatite (HA) spacer and allogeneic bone (AB) spacer in laminoplasty. Methods : From January 2006 to July 2014, 79 patients with cervical spondylotic myelopathy or ossification of the posterior longitudinal ligament underwent cervical laminoplasty. The radiologic parameters were obtained from plain radiography and three-dimensional computed tomography. All images were taken before and after surgery. Cervical lordosis, spinal canal dimension, fusion between lamina and spacer, and resorption of spacer were checked. Clinical outcomes were assessed using visual analog scale and Japanese Orthopedic Association. Results : Double-door laminoplasty was performed on 280 levels : 182 in the HA group and 98 in the AB group. The mean follow-up was 23.1 months (range : 4-69 months). Similar fusion rates were found in these groups (p=0.3). The resorption rate between lamina and spacer was lower in the HA group (p<0.001). During the immediate postoperative period, the canal dimension of both groups increased compared with the results in the preoperative period. However, the canal dimension of the AB group decreased over time compared with that of the HA group (p<0.001). Conclusion : Double-door laminoplasty improved the clinical outcomes of both groups. However, the spinal canal dimension in the AB group showed a greater degree of reduction than in the HA group at the final postoperative follow-up. Therefore, we suggest that surgeons consider the use of larger-sized AB spacers in double-door laminoplasties.

Keywords

References

  1. Chiba K, Ogawa Y, Ishii K, Takaishi H, Nakamura M, Maruiwa H, et al. : Long-term results of expansive open-door laminoplasty for cervical myelopathy--average 14-year follow-up study. Spine (Phila Pa 1976) 31 : 2998-3005, 2006 https://doi.org/10.1097/01.brs.0000250307.78987.6b
  2. Hirabayashi K, Watanabe K, Wakano K, Suzuki N, Satomi K, Ishii Y : Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine (Phila Pa 1976) 8 : 693-699, 1983 https://doi.org/10.1097/00007632-198310000-00003
  3. Iwasaki M, Kawaguchi Y, Kimura T, Yonenobu K : Long-term results of expansive laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine : more than 10 years follow up. J Neurosurg 96(2 Suppl) : 180-189, 2002
  4. Jin SW, Kim SH, Kim BJ, Choi JI, Ha SK, Kim SD, et al. : Modified open-door laminoplasty using hydroxyapatite spacers and miniplates. Korean J Spine 11 : 188-194, 2014 https://doi.org/10.14245/kjs.2014.11.3.188
  5. Kanemura A, Doita M, Iguchi T, Kasahara K, Kurosaka M, Sumi M : Delayed dural laceration by hydroxyapatite spacer causing tetraparesis following double-door laminoplasty. J Neurosurg Spine 8 : 121-128, 2008 https://doi.org/10.3171/SPI/2008/8/2/121
  6. Kawaguchi Y, Kanamori M, Ishihara H, Ohmori K, Nakamura H, Kimura T : Minimum 10-year followup after en bloc cervical laminoplasty. Clin Orthop Relat Res (411) : 129-139, 2003
  7. Kimura A, Seichi A, Inoue H, Hoshino Y : Long-term results of doubledoor laminoplasty using hydroxyapatite spacers in patients with compressive cervical myelopathy. Eur Spine J 20 : 1560-1566, 2011 https://doi.org/10.1007/s00586-011-1724-7
  8. Kimura I, Shingu H, Nasu Y : Long-term follow-up of cervical spondylotic myelopathy treated by canal-expansive laminoplasty. J Bone Joint Surg Br 77 : 956-961, 1995
  9. Kong Q, Zhang L, Liu L, Li T, Gong Q, Zeng J, et al. : Effect of the decompressive extent on the magnitude of the spinal cord shift after expansive open-door laminoplasty. Spine (Phila Pa 1976) 36 : 1030-1036, 2011 https://doi.org/10.1097/BRS.0b013e3181e80507
  10. Kubo S, Goel VK, Yang SJ, Tajima N : Biomechanical evaluation of cervical double-door laminoplasty using hydroxyapatite spacer. Spine (Phila Pa 1976) 28 : 227-234, 2003
  11. Martin-Benlloch JA, Maruenda-Paulino JI, Barra-Pla A, Laguia-Garzaran M : Expansive laminoplasty as a method for managing cervical multilevel spondylotic myelopathy. Spine (Phila Pa 1976) 28 : 680-684, 2003
  12. Nakano K, Harata S, Suetsuna F, Araki T, Itoh J : Spinous process-splitting laminoplasty using hydroxyapatite spinous process spacer. Spine (Phila Pa 1976) 17(3 Suppl) : S41-S43, 1992 https://doi.org/10.1097/00007632-199203001-00009
  13. Nakashima H, Kato F, Yukawa Y, Imagama S, Ito K, Machino M, et al. : Comparative effectiveness of open-door laminoplasty versus Frenchdoor laminoplasty in cervical compressive myelopathy. Spine (Phila Pa 1976) 39 : 642-647, 2014 https://doi.org/10.1097/BRS.0000000000000252
  14. Ogawa Y, Chiba K, Matsumoto M, Nakamura M, Takaishi H, Hirabayashi H, et al. : Long-term results after expansive open-door laminoplasty for the segmental-type of ossification of the posterior longitudinal ligament of the cervical spine : a comparison with nonsegmental-type lesions. J Neurosurg Spine 3 : 198-204, 2005 https://doi.org/10.3171/spi.2005.3.3.0198
  15. Okada M, Minamide A, Endo T, Yoshida M, Kawakami M, Ando M, et al. : A prospective randomized study of clinical outcomes in patients with cervical compressive myelopathy treated with open-door or Frenchdoor laminoplasty. Spine (Phila Pa 1976) 34 : 1119-1126, 2009
  16. Park JH, Jeon SR : Midline-splitting open door laminoplasty using hydroxyapatite spacers : comparison between two different shaped spacers. J Korean Neurosurg Soc 52 : 27-31, 2012 https://doi.org/10.3340/jkns.2012.52.1.27
  17. Patel CK, Cunningham BJ, Herkowitz HN : Techniques in cervical laminoplasty. Spine J 2 : 450-455, 2002 https://doi.org/10.1016/S1529-9430(01)00158-9
  18. Ratliff JK, Cooper PR : Cervical laminoplasty : a critical review. J Neurosurg 98(3 Suppl) : 230-238, 2003
  19. Sakaura H, Hosono N, Mukai Y, Ishii T, Iwasaki M, Yoshikawa H : Longterm outcome of laminoplasty for cervical myelopathy due to disc herniation : a comparative study of laminoplasty and anterior spinal fusion. Spine (Phila Pa 1976) 30 : 756-759, 2005 https://doi.org/10.1097/01.brs.0000157415.79713.7e
  20. Shimamura T, Kato S, Toba T, Yamazaki K, Ehara S : Sagittal splitting laminoplasty for spinal canal enlargement for ossification of the spinal ligaments (OPLL and OLF). Semin Musculoskelet Radiol 5 : 203-206, 2001 https://doi.org/10.1055/s-2001-15681
  21. Suk KS, Kim KT, Lee JH, Lee SH, Lim YJ, Kim JS : Sagittal alignment of the cervical spine after the laminoplasty. Spine (Phila Pa 1976) 32 : E656-E660, 2007 https://doi.org/10.1097/BRS.0b013e318158c573
  22. Tanaka N, Nakanishi K, Fujimoto Y, Sasaki H, Kamei N, Hamasaki T, et al. : Expansive laminoplasty for cervical myelopathy with interconnected porous calcium hydroxyapatite ceramic spacers : comparison with autogenous bone spacers. J Spinal Disord Tech 21 : 547-552, 2008 https://doi.org/10.1097/BSD.0b013e31815c85bd
  23. Tsuji H : Laminoplasty for patients with compressive myelopathy due to so-called spinal canal stenosis in cervical and thoracic regions. Spine (Phila Pa 1976) 7 : 28-34, 1982 https://doi.org/10.1097/00007632-198200710-00002
  24. Yang SC, Niu CC, Chen WJ, Wu CH, Yu SW : Open-door laminoplasty for multilevel cervical spondylotic myelopathy : good outcome in 12 patients using suture anchor fixation. Acta Orthop 79 : 62-66, 2008 https://doi.org/10.1080/17453670710014770