Lateral Mass Anchoring Screws for Cervical Laminoplasty

Abstract

STUDY DESIGN: Preliminary reporting of a group of patients with multiple level cervical spinal stenosis treated with a simple technique using lateral mass anchoring screw and unabsorbable suture line for securing the lamina position after expansive open-door laminoplasty. OBJECTIVE: To develop an improved method for laminoplasty fixation. SUMMARY OF BACKGROUND DATA: Laminoplasty is considered the standard procedure for treating multiple-level cervical spinal stenosis with myelopathy. Keys to successful laminoplasty are expanding and maintaining the spinal canal. There are many techniques for maintaining and securing of the expanded spinal canal such as fascial or joint capsule anchoring suture, spacer interposition, allograft, autograft, or miniplate fixation. However, many reports have indicated that these complicated and/or costly techniques are not superior to other techniques. This study reports a simple, reliable technique using a lateral mass anchoring screw for augmentation of laminoplasty fixation. METHODS: Five patients with multiple level cervical spinal stenosis underwent laminoplasty. A unilateral open door technique was done for the lesion level and the elevated lamina was fixed to lateral mass anchoring screws at each level using unabsorbable suture line. RESULTS: The mean follow-up period was 14.5 months (9 to 34 mo). Postoperatively, the Japanese Orthopedic Association score improved from an average of 8.6 (range: 7 to10 points) to 14.2 points (range: 13 to 15 points). The average recovery rate was 67% (60% to 75%). Follow-up computed tomography scans showed the average improvement in anterioposterior diameter at each level of the cervical canal to be about 4.0 to 7.7 mm. The average open angle at each level was 19.0 to 23.8 degrees. All hinged sides had bony fusion. CONCLUSIONS: Although this is a small series, the preliminary results suggest that this simple lateral mass anchoring screw technique can provide a firm and secure anchor for elevated open lamina in laminoplasty.