Laminoplasty is a common surgical technique used to treat cervical myelopathy. When the problem occurs in your upper spine and neck, a cervical laminoplasty needs to be performed. Implant selection verify that all parts and necessary instruments are present. This technique guide describes a surgical technique used by. Spinal laminoplasty market global industry analysis, size, share. Cervical laminoplasty is a surgical procedure to remove pressure on the spinal cord in the neck, in the form of spinal stenosis, or narrowing of the spinal canal. Laminoplasty was major surgical advancement as laminectomy. The name of the procedure is derived from the latin word lamina thin plate, sheet or layer, and the greek term plastos to mold. Techniques of laminoplasty and supplementary procedures. Hirabayashi then introduced the opendoor laminoplasty technique in 1977, followed by the kurokawa doublehinge, or french door technique in 1980. For example, depuy synthes introduced mountaineer laminoplasty.
There were several hopes for cervical laminoplasty. Laminoplasty can be a technically demanding procedure when operating on myelopathic. The surgeon cuts the lamina on both sides of the vertebrae. Pinched or compressed nerves may result from herniated discs, lumbar spinal stenosis, or spondylolisthesis the traditional technique for decompression of lumbar nerves is laminectomy, a surgical procedure developed in the early 1900s. Images on the graft loading block will assist with the correct orientation of the allograft to the plate. The cervical laminoplasty surgical procedure relieves the painful pressure of spinal stenosis by creating more space for the spinal cord and nerve roots. Cervical laminoplasty new york city laminoplasty surgery. The most common reason for failure of this technique is restenosis due to hinge closure.
The global spinal laminoplasty market is expected to witness remarkable growth over the coming seven years owing to increasing demand for minimally invasive surgical procedures coupled with associated advantages such as. Various techniques have been employed to hold the laminar door open while the body heals the lamina hinge in the new expanded position. The application of this technique is predicated on maintenance of physiologic sagittal alignment in the cervical spine. The gallery laminoplasty fixation system holds or buttresses the allograft in place in order to prevent the allograft from expulsion or impinging on the spinal cord. Cervical laminoplasty surgery cervical laminoplasty. The clinical material consists of 54 cases with more than 3 years followup. Yet, outcomes in laminoplasty patients that are at least as good as anterior decompression and fusion and laminectomy can be expected. Cervical spondylotic myelopathy can result from degenerative cervical spondylosis, herniated disk material, osteophytes, redundant ligamentum flavum, or ossification of the posterior longitudinal ligament. Posterior surgical techniques for cervical spondylotic. Laminoplasty techniques for the treatment of multilevel. Ten years after laminoplasty by the doubledoor technique, 78% of patients maintain their initial improvement in degree of myelopathy. Laminoplasty is a motionsparing decompression technique for the cervical spine.
Laminoplasty is a surgical technique through which compression on affected nerves is reduced. Neck pain following laminoplasty pubmed central pmc. Escalate t laminoplasty system surgical technique 6 expandable laminoplasty plate technique lifting the lamina after the laminar trough and hinge have been prepared, the lamina elevator can be used to lift the fullycut lamina. Expansive opendoor laminoplasty is widely accepted as a reliable procedure for cervical myelopathy. Both voids and contradictory information exist in the literature with regard to the initial and longterm biomechanical consequences of cervical laminoplasty. However, one acknowledged complication is springback complication or closure of the door which may result in restenosis of cervical canal and neurologic deterioration. This essentially created an asymmetric expansion of the canal. Electric pen drive and air pen drive to ease the work and decrease surgical time during laminoplasty the use of an appropriate power tool can be helpful.
Escalate laminoplasty system this system features an expandable laminoplasty plate, a base laminoplasty plate, bone screws for fixation, and a set of instruments that are designed to give you a systematic approach to your lower cervical and upper thoracic laminoplasty procedures. Posterior surgical techniques for csm include laminectomy alone, laminectomy with fusion, and laminoplasty. Expansive opendoor laminoplasty secured with titanium. These techniques are often used if there are 3 or more levels of anterior compression. Home care instructions after cervical laminoplasty surgery. In order to avoid these disadvantages, a new surgical technique called expansive opendoor laminoplasty was devised by the author in 1977, which is relatively easier, safer, and better than the. Neurological complications of cervical laminoplasty for. It can be attached directly to the lamina above and to the lateral mass beneath the hinge. The spinous processsplitting laminoplasty described by watanabe et al 14,15 as an alternative technique to decompress the lumbar spine has the advantage of a traditional midline approach that. Subsequently described techniques for laminoplasty are modifications of these two principal concepts, with variations seen in how the laminoplasty is held open as well as the exposures used. Using the plate holder, the corresponding plate is then inserted by fitting the cut edge of the lamina into the laminar.
The goal of a laminoplasty is to relieve pressure on the spinal cord. In order to clarify the existing literature, as well as provide clinically useful information, we identified three specific aims. We prefer an opendoor laminoplasty technique, as originally described by hirabayashi. Study design retrospective evaluation of prospectively collected data objective to compare preoperative and postoperative neck pain following laminoplasty using the neck disability index ndi methods seventytwo patients undergoing laminoplasty from 2006 to 2009 at a single institution were identified. This information is intended for use by customers, patients, and healthcare professionals in the united states only. Laminoplasty is a motion preserving surgery, meaning that no fusion is performed, and motion is not changed. Laminoplasties are performed by experienced spinal surgeons on patients who are fully anesthetized. In the laminoplasty group, the interspinous ligaments were cut at the superior and inferior ends of the target levels, with the supraspinous ligaments entirely preserved. Cervical laminoplasty is a surgical technique that relieves pressure on the spinal cord. Surgical intervention for multilevel myelopathy aims to decompress the spinal cord and maintain stability of the cervical spine. The ideal surgical technique and implant design minimize damage to anatomical structures, i. The electric pen drive and air pen drive are pen shaped, highspeed systems, supporting surgeons for example in performing a laminoplasty.
Laminoplasty describes the process of increasing the space available for the spinal cord by reconstruction of the laminar arch via a posterior approach. Depuy spine launches mountaineer laminoplasty system. Posterior cervical decompression and laminoplasty surgical technique a posterior cervical decompression and laminoplasty is a common surgical procedure to treat pain andor narrowing in the cervical spine neck. Spinal laminoplasty is a surgical procedure performed to remove pressure from. It was developed to avoid the significant risk of complications associated with alternative surgical options such as. Spinal laminoplasty market global industry analysis. The following occipitocervicothoracic surgical technique guide, describes the recommended placement and use of all mountaineer oct spinal system. Laminoplasty is an effective procedure for treating cervical spondylotic myelopathy csm.
The laminoplasty procedure was created by japanese orthopedic surgeons during the 1970s to 1980s. Laminoplasty is a procedure performed to increase the width of the spinal canal for the purpose of relieving pressure on the spinal cord. We recognize that the internet is a global communications medium. Subjects comprised 581 patients 458 men and 123 women. The gallery laminoplasty fixation system is intended for use in the lower cervical and upper thoracic spine c3t3 after a laminoplasty has been performed. This study is aimed to elucidate the efficacy of and problems associated with eolp secured with titanium miniplates without.
Little information is available regarding the surgical outcomes of expansive opendoor laminoplasty eolp when securing with titanium miniplates without bone grafting. Laminoplasty spinal surgery treatment virginia spine. This instrument is designed such that the expandable laminoplasty plate can fit between the prongs of the lamina. The procedure is frequently referred to as open door laminoplasty because of the method in which the lamina is altered. Cervical laminoplasty north american spine society. Laminaplasty is a surgical procedure that treats a painfully restricted spinal canal by creating more space for the spinal cord and nerve roots, immediately relieving pressure. In the appropriate patient and with proper surgical technique, laminoplasty can be an excellent option for patients with multilevel cervical stenosis and myeloradiculopathy. Spinal laminoplasty is a surgical procedure performed to remove pressure from the spinal cord. In the french door laminoplasty, the door is opened in the midline and thus creates a symmetric opening of the canal 32. Hence these two procedures are described in more detail. Posterior surgical decompression is an effective technique for improving the neurological function of patients with csm. Pressure on the spinal cord can be due to various causes including degenerative changes, arthritis, bone spurs, disc herniations, opll, tumors, or fractures.
Laminoplasty is one surgical option for cervical spondylotic myelopathy. The system features an expandable laminoplasty plate, a base laminoplasty plate, bone screws for fixation, and a set of instruments to assist in implantation and removal of the device, if necessary. It must be emphasized that one technique has not be. The securespan laminoplasty fixation system provides a comprehensive solution, which enables a safe, quick and effective fixation for laminoplasty procedures. Goal of laminoplasty surgery is to relieve the narrowing of spinal canal. The first laminoplasty technique developed was from modifying the miyazaki and kiritas technique for laminectomy. Standard, allograft for use with allograft bone spacer and salvage plates are offered, along with selfdrilling and selftapping screws. All of these variations are designed to reposition the laminae and. As the first description was published over 40 years ago, it has been established as an effective treatment for cervical spondylotic myelopathy. Thirtyfour patients with a minimum 1year followup who completed preoperative, 6. Securespan laminoplasty surgical technique youtube. A laminoplasty is a surgical procedure that creates more space for the spinal cord and nerve roots to relieve abnormal pressure on the spinal cord. Laminotomy 1 is the surgical removal and subsequent reinsertion of laminae and spinous processes, whereas laminectomy represents the removal of the lamina and the spinous process. Expanding laminoplasty for cervical myelopathyspinous.
Over the years, laminoplasty has evolved its technique. All the surgical techniques were performed by the same surgeon, senior author jhv, using the same method. Another technique, known as a french door laminoplasty, creates hinges on both sides of the lamina and an opening in the center, allowing the lamina to be opened by. Cervical opendoor laminoplasty technique with simple. Cervical laminoplasty is a surgical technique that removes pressure from the spinal cord in the neck. Cervical laminoplasty was developed by hirabayashi in 1977 to obviate the risk of postlaminectomy complications. This pressure can be caused by a host of issues, from degenerative changes and arthritis to bone spurs and disc herniations. It is most commonly done to treat spinal stenosis, a condition characterized by narrowing of the spinal canal.
Arch laminoplasty system depuy synthes depuy synthes 1 table of contents introduction overview 2 ao asif principles 4 indications and contraindications 5 product information implants 6 instruments 8 vario case 10 surgical technique laminotomy 11 a. Depuy spine developed the mountaineer laminoplasty system to. Cervical laminoplasty had been developed in japan for many years to overcome the drawbacks of laminectomy. The escalate system is a comprehensive set of implants and instruments designed for a systematic approach to cervical laminoplasty procedures.
Utilizing the open door plate plate positioning the appropriate size laminoplasty plate for each level is selected using the bone trials figure 10. The gallery laminoplasty fixation system provides a simplified approach to instrumented laminoplasty procedures. The result shows that laminoplasty with this technique provides better postoperative neck movement with a simpler surgical procedure. Mountaineer laminoplasty system surgical technique. If you have any questions or concerns, please ask your nurse or doctor.
Know what is laminoplasty, who is a candidate for this procedure, how is laminoplasty done, what is the recovery period following laminoplasty and. This type of cervical spine surgery is done in the neck. The graft loading block is designed so that, when placed correctly, the allograft will. Pressure on the spinal cord can be due to various causes. Spinal laminoplasty market size, share global industry report, 2025. Microsurgical lumbar laminoplasty is a minimally invasive technique for decompressing pinched nerves in the lumbar spine. Cervical laminoplasty for multilevel cervical myelopathy. Cervical laminoplasty is a technique used to achieve spinal cord decompression in cases of myelopathy or myeloradiculopathy. The proper atraumatic technique enables minimal retraction or disturbance of the nerve roots and dura, and maintains the stability of the facet joints.
The new system enables spine surgeons to maintain a secure grasp of the. Because only two troughs are required, it is a bit more timeefficient than a frenchdoor procedure. In the opendoor expansive laminoplasty, the canal is opened on one side and hinged on the other. However, there may be greater degrees of frustration. It was developed to avoid the significant risk of complications associated with alternative surgical options such as anterior decompression and fusion and laminectomy with or without posterior fusion. In laminoplasy, an extra space is made in the spinal canal by creating a gate or opening in the lamina of the vertebrae for the ease of spinal cord movement. Various laminoplasty techniques have been described. The basic concept of most of procedures is similar to one of these two procedures fig. The securespan laminoplasty fixation system provides a comprehensive solution, which enables a safe, quick and effective fixation for. However, perioperative neurological complication rates of laminoplasty for cervical opll have not been well described. We have carried out expanding laminoplasty using spinous process roofing technique for patients presenting with cervical myelopathy. The surgical technique is presented in a simple, stepwise fashion that will enable trained, experienced spinal surgeons to obtain reproducible success.
Depuy spine recently launched the mountaineer laminoplasty system of implants and instruments for posterior decompression of the cervical spine, according to a company news release. This method was described by oyama as zshaped laminoplasty. Escalate t laminoplasty system surgical technique 4 base laminoplasty plate the base laminoplasty plate can be used to reinforce an unstable hinge after a laminoplasty procedure. Patient positioning patient positioning is critical during laminoplasty to avoid complications. To complete the procedure, the surgeon creates an incision on. As much as possible, laminoplasty is performed as a motionpreserving procedure, intended to leave the full range of motion in the affected spinal segment intact. Surgical technique this package insert is designed to assist in using the product and is not intended to provide information on surgical technique.