Cervical laminoplasty can achieve spinal cord decompression in cases of multi-level myelopathy or myeloradiculopathy due to cervical spondylosis, ossification of the posterior longitudinal ligament (OPLL), and similar conditions.The most common reason for failure of laminoplasty has been re-stenosis due to hinge closure. Various techniques have been employed to hold the door open while the host heals the laminar hinge in the expanded position. Ideally, a method of achieving laminar fixation should be technically intuitive, provide secure laminar fixation, while minimizing the risk of iatrogenic injuries, blood loss and operative time.
The authors describe the use of the novel CENTERPIECE™: Plate Fixation System designed to accomplish these goals during Open Door laminoplasty. The technical issues relevant to performing the laminoplasty and securing the laminae are discussed. The plates have been proven to be biomechanically equivalent to the currently-used techniques. The use of these plates will potentially allow the patient to engage in an early active rehabilitation protocol while minimizing the risk of re-stenosis of the canal. This may ultimately lead to better preservation of motion and decreased axial neck pain following laminoplasty.
Benefits:
- Anatomic contouring
- Ease of application
- Secure laminar fixation
- Adaptability to procedures with and without allograft
- Facilitation of early active motion and rehabilitation
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