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All levels versus alternate levels plate fixation in expansive open door cervical laminoplasty

  • Original Article
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Abstract

Background

Expansive open door laminoplasty with the use of titanium miniplate is becoming popular. Usually, the plate is applied at each level to prevent re-closure of the opened lamina. However, it is also used at alternating levels (i.e., C3, C5 and C7) in clinical settings in order to reduce the cost. Whether they have any difference in clinical efficacy? There is a lack of comparative data between the two kinds of plate fixation in the literature.

Materials and Methods

83 patients who underwent cervical laminoplasty with alternating levels plate fixation (51 patients in Group A) or all levels plate fixation (32 patients in Group B) between January 2008 and October 2012 were evaluated in our institute retrospectively. Clinical and radiologic outcomes were assessed.

Results

No statistical difference was found in the mean operation time, blood loss, incidence of significant axial symptoms and C5 palsy, preoperative anteroposterior diameter (APD) and preoperative Japanese Orthopedic Association score between the two groups. However, Group B showed a higher rate of neurologic recovery after surgery. Postoperative increased APD and open angle in Group B were significantly larger than Group A. The mean cost for Group B (12801 ± 460.6 USD) was higher than Group A (8906 ± 566.7 USD).

Conclusions

Despite the higher cost of all level fixation, it is more effective in maintaining the expansion of the spinal canal and can obtain better clinical improvement compared to alternating levels fixation.

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Authors and Affiliations

  1. Department of Orthopedics, 1st Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, China

    Zheng-Fei Wang, Guang-Dong Chen,  Hui-Lin Yang & Jun Qian

  2. Departments of Orthopedics, Changshu No. 1 People’s Hospital, Changshu, 215500, Jiangsu Province, China

    Zheng-Fei Wang, Feng Xue & Xiao-Wen Sheng

Authors
  1. Zheng-Fei Wang
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  2. Guang-Dong Chen
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  3. Feng Xue
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  4. Xiao-Wen Sheng
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  5. Hui-Lin Yang
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  6. Jun Qian
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Corresponding author

Correspondence to Hui-Lin Yang.

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Wang, ZF., Chen, GD., Xue, F. et al. All levels versus alternate levels plate fixation in expansive open door cervical laminoplasty. IJOO 48, 582–586 (2014). https://doi.org/10.4103/0019-5413.144225

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  • DOI: https://doi.org/10.4103/0019-5413.144225

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