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Objective To analyze correlations between the selection of microtitanium plates with different specifications for use in a cervical vertebral dome expansion laminoplasty. Methods Sixteen patients that underwent the cervical vertebral dome expansion laminoplasty with a cervical spinal stenosis angioplasty procedure for treatment of their cervical spinal cords were recruited at our hospital. From February 2017 to September 2018, medical records confirmed that all patients underwent cervical CT and MRI tests pre‐ and postsurgery. The anteroposterior diameter of the spinal canal, changes in the cross‐sectional area of the spinal canal, and the pre‐ and postsurgery distance of the cervical spinal cord after applying microtitanium plates with different lengths were measured by Mimics version 17.0 software (Materialise NV, Leuven, Belgium). A statistical regression and correlation analysis of relevant specification parameters of the microtitanium plate was then studied. Results As the size of the microtitanium plate increased, we found that the cross‐sectional area of cervical spinal canal and distance between the descendants of the lamina and the distance of cervical spinal cord concordantly increased, and these data changes linearly. The regression equation associated with sagittal diameter, cross‐sectional area, and posterior movement distance of the cervical spinal cord was obtained. Conclusion According to the correlation analysis of imaging data changes, the regression equation was obtained to guide the selection of microtitanium plates with appropriate specifications in a cervical vertebral dome expansion laminoplasty.

Purpose To provide imaging evidence of the feasibility and clinical efficacy of a new full lamina back shift spinal canal enlargement technique. Methods A retrospective analysis was conducted on 64 patients with multisegment cervical spondylotic myelopathy caused by cervical stenosis. Of these, 32 patients underwent the new full lamina back shift spinal canal enlargement technique (as observation group) and 32 patients underwent single open‐door miniature titanium plate internal fixation (as control group). The computed tomography (CT) data of both groups were imported into Mimics 17.0 software to measure the median sagittal diameter and cross‐sectional area of the spinal canal. Photoshop CS5 was employed to measure the drift distance of the spinal cord on MR images to perform a comparative study of the imaging parameters from the two groups. Results The T2‐weighted MR images in both groups showed continuous recovery of the cerebrospinal fluid signal in the C3–C7 range. The enlarged spinal canal cross‐sectional area (mm2) of each segment after the new full lamina back shift spinal canal enlargement technique was 130.90 ± 20.52 (C3), 180.81 ± 18.86 (C4), 240.48 ± 35.43 (C5), 145.93 ± 36.94 (C6), and 153.16 ± 36.28 (C7), and the enlarged median sagittal diameter (mm) was 5.31 ± 1.13 (C3), 8.8 ± 1.28 (C4), 10.28 ± 1.68 (C5), 9.46 ± 1.48 (C6), and 9.22 ± 1.12 (C7). Both parameters were significantly superior to single open‐door miniature titanium plate internal fixation (P 0.05). Conclusion The new full lamina back shift spinal canal enlargement technique achieved a thorough spinal canal decompression effect on imaging while ensuring a reasonable spinal drift distance and few surgical complications. The clinical curative effect of the new technique was precise.

Objective: To analyze correlations between the selection of microtitanium plates with different specifications for use in a cervical vertebral dome expansion laminoplasty. Methods: Sixteen patients that underwent the cervical vertebral dome expansion laminoplasty with a cervical spinal stenosis angioplasty procedure for treatment of their cervical spinal cords were recruited at our hospital. From February 2017 to September 2018, medical records confirmed that all patients underwent cervical CT and MRI tests pre‐ and postsurgery. The anteroposterior diameter of the spinal canal, changes in the cross‐sectional area of the spinal canal, and the pre‐ and postsurgery distance of the cervical spinal cord after applying microtitanium plates with different lengths were measured by Mimics version 17.0 software (Materialise NV, Leuven, Belgium). A statistical regression and correlation analysis of relevant specification parameters of the microtitanium plate was then studied. Results: As the size of the microtitanium plate increased, we found that the cross‐sectional area of cervical spinal canal and distance between the descendants of the lamina and the distance of cervical spinal cord concordantly increased, and these data changes linearly. The regression equation associated with sagittal diameter, cross‐sectional area, and posterior movement distance of the cervical spinal cord was obtained. Conclusion: According to the correlation analysis of imaging data changes, the regression equation was obtained to guide the selection of microtitanium plates with appropriate specifications in a cervical vertebral dome expansion laminoplasty. [ABSTRACT FROM AUTHOR]

Purpose To provide imaging evidence of the feasibility and clinical efficacy of a new full lamina back shift spinal canal enlargement technique. Methods: A retrospective analysis was conducted on 64 patients with multisegment cervical spondylotic myelopathy caused by cervical stenosis. Of these, 32 patients underwent the new full lamina back shift spinal canal enlargement technique (as observation group) and 32 patients underwent single open‐door miniature titanium plate internal fixation (as control group). The computed tomography (CT) data of both groups were imported into Mimics 17.0 software to measure the median sagittal diameter and cross‐sectional area of the spinal canal. Photoshop CS5 was employed to measure the drift distance of the spinal cord on MR images to perform a comparative study of the imaging parameters from the two groups. Results: The T2‐weighted MR images in both groups showed continuous recovery of the cerebrospinal fluid signal in the C3–C7 range. The enlarged spinal canal cross‐sectional area (mm2) of each segment after the new full lamina back shift spinal canal enlargement technique was 130.90 ± 20.52 (C3), 180.81 ± 18.86 (C4), 240.48 ± 35.43 (C5), 145.93 ± 36.94 (C6), and 153.16 ± 36.28 (C7), and the enlarged median sagittal diameter (mm) was 5.31 ± 1.13 (C3), 8.8 ± 1.28 (C4), 10.28 ± 1.68 (C5), 9.46 ± 1.48 (C6), and 9.22 ± 1.12 (C7). Both parameters were significantly superior to single open‐door miniature titanium plate internal fixation (P < 0.05). No significant difference was detected in the drift distance of the spinal cord between the two groups (P > 0.05). Conclusion: The new full lamina back shift spinal canal enlargement technique achieved a thorough spinal canal decompression effect on imaging while ensuring a reasonable spinal drift distance and few surgical complications. The clinical curative effect of the new technique was precise. [ABSTRACT FROM AUTHOR]

Study Design: Retrospective study.Objective: To determine the optimal open side in unilateral open-door laminoplasty (UODL) for lateral cervical ossification of posterior longitudinal ligament (OPLL).Summary Of Background Data: No literature has reported which side of the vertebral arch should be chosen as the open side in UODL for lateral cervical OPLL.Methods: Patients with lateral cervical OPLL who were treated with UODL between 2013 and 2018 were retrospectively analyzed in two groups: Group A, where the open side was contralateral to the ectopic bone, and Group B, where the open side was ipsilateral to the ectopic bone. The Japanese Orthopaedic Association (JOA) Score, JOA recovery rate, spinal canal enlargement rate, cervical range of motion (ROM), and spinal cord area (SCA) were measured to evaluate and compare the clinical outcomes between the two groups. Statistical analysis was performed by t test and Hotelling T2 test.Results: There was no significant difference in patient demographics and major complications between the two groups. The postoperative JOA Score and JOA recovery rate in Group A were significantly higher than those in Group B. There was no significant difference in cervical ROM within or between the two groups during the 2-year follow-up period, nor was there significant difference in spinal canal enlargement between the two groups. However, both postoperative SCA and increased SCA in Group A were significantly higher than those in Group B.Conclusion: The contralateral open side approach is preferable to the ipsilateral open side approach in UODL for lateral cervical OPLL.Level Of Evidence: 3. [ABSTRACT FROM AUTHOR]

: Background contextMultilevel fenestration or laminectomy is generally performed to treat the patient with lumbar canal stenosis (LCS). However, in patients requiring laminectomy, little attention has been paid to the later development of lumbar pain possibly caused by a removal of the posterior elements of the spine. In general, spinal instrumentation and fusion has been generally performed when laminectomy might cause severe postoperative spinal instability. Surgical methods where osteotomized vertebral arches are repositioned rather than removed have long been performed. However, they have never become widespread, possibly because of the complicated surgical procedures and poor postoperative arch stability, which leads to a long period of postoperative immobilization.: PurposeThe purpose of the present report was to introduce our surgical procedures of spinal canal enlargement using restorative laminoplasty and to report the results.: Study design/settingThis retrospective study was conducted to analyze the clinical results in 33 patients with lumbar canal stenosis who had been treated by our surgical procedures of spinal canal enlargement using restorative laminoplasty.: Patient sampleSubjects were 33 patients followed for at least 2 years after surgery. Meyerding Grade I degenerative spondylolisthesis was found in 10 patients, and degenerative scoliosis of more than 5 degrees was seen in 20 patients. Nine patients demonstrated both degenerative spondylolisthesis and degenerative scoliosis.: Outcome measuresUsing the Japanese Orthopedic Association (JOA) scoring system, lumbago, sciatica, leg numbness, muscle strength and gait were quantified before surgery, 1 year after surgery and at final examination (at least 2 years after surgery) to calculate improvement rates. Furthermore, correlations to age, gender, disease duration, degenerative spondylolisthesis and degenerative scoliosis were statistically analyzed.: MethodsOur surgical procedures of spinal canal enlargement using restorative laminoplasty were performed for all patients. In our procedures, posterior elements were reapplied with an absorbable fixation (poli-L-lactic acid pins). No other fusion procedure was performed jointly.: ResultsThe mean number of restored vertebral arches was 2.2, and mean surgery time was 131 minutes. Mean volume bleeding during surgery was 328.0 ml. In all patients, successful bone healing was obtained at a mean of 5 months after surgery. Mean improvement rate for the total JOA score was 80.6%. Mean improvement rates for lumbago and sciatica were 70.0% and 87.7%, respectively. Mean improvement rate for leg numbness was 50.8%. Mean improvement rates for leg muscle strength and intermittent claudication were 70.0% and 98.9%, respectively.No significant correlation was found between gender and overall improvement rate, between age and overall improvement rate, between age and leg numbness or between number of restored vertebral arches and overall improvement rate. The tendency was that the longer the disease duration, the lower the overall improvement rate, and the more severe the residual numbness. No significant correlation was found between disease duration and muscle strength or lumbago.A significant correlation was not found between the presence of preoperative Grade I degenerative spondylolisthesis and overall improvement rate or lumbago. However, a significant difference in severity of lumbago existed between patients with degenerative scoliosis of 9 degrees and below and those with degenerative scoliosis of 10 degrees and above.: ConclusionOur surgical procedures of spinal canal enlargement using restorative laminoplasty produce complete decompression and anatomical reconstruction of the posterior elements, ligaments and muscles. Improvement in complaints of lumbago may be a consequence of the anatomical reconstruction of the posterior spinal elements. Overall, favorable results were obtained. The best results were obtained if surgery is performed within 2 years of the onset of LCS. [Copyright &y& Elsevier]