Open door laminoplasty is an alternative treatment for spinal stenosis 723. Influence of extending expansive opendoor laminoplasty to c1. Degeneration of the vertebral column and associated soft tissue can compress the spinal cord, leading to pain, numbness or loss of motor abilities. The various steps of the procedure are shown from exposure to the c3c7 cervical spine, burring of the laminas to open the door and insertion of prosthetic grafts. Comparative effectiveness of opendoor laminoplasty vs. Opendoor laminoplasty had significantly reduced cervical range of motion than. Oot french door laminoplasty for cervical spondylotic. Jan 01, 2004 open door cervical laminoplasty was originally developed in japan by hirabayashi for the treatment of multilevel cervical spondylotic myelopathy csm 4, 15. We describe the technique of opendoor and frenchdoor cervical laminoplasty and present our clinical results. The following is the supplementary data to this article. In the french door laminoplasty, the door is opened in the midline and thus creates a symmetric opening of the canal 32. Objectives expansive opendoor laminoplasty eolp is effective for multilevel cervical.
Open door laminoplasty odl and french door laminoplasty fdl are used to treat cervical multilevel compressive myelopathy. The surgeon cuts through the lamina on one side of the spinous process at the affected levels and notches the. In cases of open door laminoplasty, postoperative cervical alignment became more kyphotic and cervical range of motion was more restricted than that in french door laminoplasty cases after surgery. Comparison of laminoplasty versus laminectomy and fusion. Several types of laminoplasty exist such as z plasty, opendoor laminoplasty, and frenchdoor laminoplasty with variable modifications. Opendoor laminoplasty odl and frenchdoor laminoplasty fdl are used to treat cervical multilevel compressive myelopathy. Bilateral troughs are drilled on each laminae using a bur, and opened liked a frenchdoor, allowing the spinal cord to move posteriorly in the enlarged spinal canal. Clinical recovery after 5 level of posterior decompression spine. At present, the surgical methods of cervical laminoplasty are classified into two types, namely opendoor laminoplasty odl and frenchdoor laminoplasty fdl. Jan 20, 2015 double door french door cervical laminoplasty openoperatingtheatre. The goal of laminoplasty is to reposition the laminae to expand the spinal canal, allowing the spinal cord to migrate posteriorly. During a cervical laminoplasty, the posterior muscles are detached and small cuts are made in the posterior cervical laminae. Clinical outcomes following cervical laminoplasty for 19. Cervical kyphosis or instability, bilateral radiculopathy due to foraminal stenosis, involvement of c2 or c7.
Two main methodological schools emerged and developed the open door laminoplasty and the frenchdoor method, and since then, there have been numerous variations of these techniques. Opendoor cervical laminoplasty with preservation of. This study explores the extension of expansive opendoor laminoplasty eodl to c1 and c2 for the treatment of cervical spinal stenosis of the upper cervical spine and its effects on cervical sagittal parameters. Doubledoor laminoplasty also known as french door, spinous process splitting, midline opening, or tsaw laminoplasty. Hirabayashi then introduced the opendoor laminoplasty technique in 1977, followed by the kurokawa doublehinge, or french door technique in 1980. Two types of laminoplasty for cervical spondylotic myelopathy. The doubledoor laminoplasty creates an opening in the midline of the spinous processes and a symmetrical expansion with hinges on both laminae. This technique allows c5 fo raminotomy on both sides. Moreover, most of the research has not been well designed. Ken is an active individual who owns his own business and takes pride in staying physically fit. Clinical application of a new plate fixation system in. The study sample is a published research articles on comparative effectiveness and functional outcome of open door versus french door laminoplasty for multilevel cervical myelopathy on the internet through databases on pubmed and proquest and published between 1997 until december 2018. Expansive open door laminoplasty for cervical spondylotic myelopathy.
One side of the bone is completely cut, while the other side acts as a hinge. Instead of one open door, as described by hirabayashi, the goal of this procedure is to obtain two open doors that will be united in the middle between c4 and c5 by sutures. Regenos spacers are not suitable for opendoor laminoplasty because of serious adverse events caused by their insufficient mechanical strength. Comparative effectiveness and functional outcome of opendoor. Clinical outcome and safety study of a newly developed. Bilateral troughs are drilled on each laminae using a bur, and opened liked a french door, allowing the spinal cord to move posteriorly in the enlarged spinal canal. The part of the vertebrae that is cut is called the lamina. The choice of frenchdoor laminoplasty or opendoor laminoplasty was. The laminae are then lifted to increase space in the spinal canal. Expansive laminoplasty has gradually become a preferred procedure for almost all patients with cervical spondylotic myelopathy with multilevel spinal stenosis. This study aims to determine comparative effectiveness and. Hirabayashi k 1978 expansive opendoor laminoplasty for cervical spondylotic myelopathy, in japanese shujutsu 32. Expansive opendoor laminoplasty also known as the hirabayashi, openhinged, or singledoor technique hirabayashi et al. Laminoplasty techniques for the treatment of multilevel.
Expansive opendoor laminoplasty secured with titanium miniplates is a good surgical method for multiplelevel cervical stenosis. When debilitating neck pain affected his work and home life he met with university orthopedics. A new expansive twoopendoors laminoplasty for multilevel cervical spondylotic myelopathy. Hirabayashi et al1 introduced unilateral opendoor laminoplasty, which has been widely used worldwide. There are many variations of laminoplasty, such as en bloc, opendoor, and doubledoor also know as french door. Degenerative cervical myelopathy due to multilevel subaxial spinal canal stenosis. A new expansive twoopendoors laminoplasty for multilevel. Expansive opendoor laminoplasty secured with titanium miniplates. Since cervical laminoplasty was first introduced by oyama and moriwaki with the name of expansive z laminoplasty in 1972, various types of cervical laminoplasty have been developed. We describe the technique of open door and french door cervical laminoplasty and present our clinical results. This is known as an open door laminoplasty because the position of the bone resembles a door being held open by a doorstop. In the classic open door laminoplasty technique, the lamina door is tethered open. Laminoplasty is a motion preserving surgery, meaning that no fusion is performed, and motion is not changed. Laminoplasty techniques for the treatment of multilevel cervical.
P osterior cervical surgery open door laminoplasty. Bone graft or metal plates are often placed along the opening to maintain their open position. Aug 08, 2018 ken is an active individual who owns his own business and takes pride in staying physically fit. Clinical indicators of surgical outcomes after cervical. Expansive opendoor laminoplasty is widely accepted as a reliable procedure for cervical myelopathy. Although opendoor laminoplasty odl is a wellknown and frequently utilized technique for the treatment of cervical myelopathy, longterm followup studies demonstrate results consistent with significant postoperative loss of motion. What is open door laminoplasty, and how should i code for it. The authors themselves acknowledge that there are many different laminoplasty techniques involved in these studies. Opendoor cervical laminoplasty was originally developed in japan by hirabayashi for the treatment of multilevel cervical spondylotic myelopathy csm 4, 15.
French door laminoplasty in the opendoor expansive laminoplasty, the canal is opened on one side and hinged on the other. Both eolp and frenchdoor laminoplasty became popular, and multiple subtypes of these operations were developed 9. Pdf expansive opendoor laminoplasty secured with titanium. In this technique, a hinge is created on one side of the laminaspinous processligamentum flavum complex. To investigate treatment differences, we performed a. Regenos spacers are not suitable for open door laminoplasty because of serious adverse events caused by their insufficient mechanical strength. On this platform we show films of thematically selected complex surgeries and of course also many standard spine surgery procedures, produced in close cooperation between international spine specialists and the european spine journal. Comparison of laminoplasty versus laminectomy and fusion in. Opendoor laminoplasty is an alternative treatment for spinal stenosis 723. 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. Double door french door cervical laminoplasty youtube. Expansive opendoor laminoplasty versus laminectomy and instrumented fusion for cases with cervical ossification of the posterior longitudinal ligament and straight lordosis.
Expansive opendoor laminoplasty is used widely for the treatment of cervical spondylosis and ossification of the posterior longitudinal ligament opll. Open door laminoplasty international journal of spine. In the classic opendoor laminoplasty technique, the lamina door is tethered open. Double door french door cervical laminoplasty openoperatingtheatre. The study aimed for addressing our cervical opendoor laminoplasty technique with sutures. At present, the surgical methods of cervical laminoplasty are broadly divided into two types from the viewpoint of the site of osteotomy. Fujimura y, nishi y, nakamura m 1997 dorsal shift and expansion of the spinal cord after expansive opendoor laminoplasty. Influence of extending expansive opendoor laminoplasty to. This manuscript demonstrates a doubledoor laminoplasty otherwise known as a frenchdoor laminoplasty discusses the indications and. Laminoplasty is an orthopaedicneurosurgical surgical procedure for treating spinal stenosis by.
This essentially created an asymmetric expansion of the canal. Several types of laminoplasty exist such as z plasty, open door laminoplasty, and french door laminoplasty with variable modifications. The surgeon cuts through the lamina on one side of the spinous process at. Cervical opendoor laminoplasty technique with simple sutures. Opendoor versus frenchdoor laminoplasty for the treatment. Comparative effectiveness of open door laminoplasty versus french door laminoplasty in cervical compressive myelopathy. The c2 to c7 laminae are drilled at the lateral borders of the laminae. Nakashima h, kato f, yukawa y et al 2014 comparative effectiveness of opendoor laminoplasty versus frenchdoor laminoplasty in cervical compressive myelopathy. The pressure on the spinal cord can be due to a variety of reasons, including a herniated or fractured disc, degeneration, or arthritis. The impetus for this new procedure was based on three surgical problems. The surgeon uses a spacer made out of bone, metal or plastic, which is inserted to keep the spinal canal open. Although open door laminoplasty odl is a wellknown and frequently utilized technique for the treatment of cervical myelopathy, longterm followup studies demonstrate results consistent with significant postoperative loss of motion.
Efficacy of modified expansive opendoor laminoplasty for. Opendoor cervical expansile laminoplasty neurosurgery. Open door laminoplasty, or cervical laminoplasty, describes a technique in which the surgeon decompresses the spinal cord while retaining structural support for the vertebral column. In the doubledoor type, osteotomy is performed at the. Laminoplasty spinal surgery treatment virginia spine. Cervical posterior surgery depicts an open door laminoplasty procedure. This study explores the extension of expansive opendoor laminoplasty eodl to c1 and c2 for the treatment of cervical spinal stenosis of the upper cervical spine and its effects on cervical. In the opendoor type, osteotomy is performed at one side of the laminafacet junction. B and d, axial and posterior view of opening of the laminoplasty door and closure of. Since being developed by hirabayashi in 1977, opendoor laminoplasty has become an established procedure for the treatment of cervical myelopathy with similar length of stay and clinical improvement to laminectomy. Open operating theatre is a proud partner of the new online postgraduate educational platform eccelearning.
Expansive open door laminoplasty is widely accepted as a reliable procedure for cervical myelopathy. What is opendoor laminoplasty, and how should i code for it. We aimed to compare the clinical outcomes of microscopeassisted extensor musclepreserving laminectomy maempl and opendoor laminoplasty odlp in treating multilevel cervical spondylotic myelopathy mcsm. This manuscript demonstrates a doubledoor laminoplasty otherwise known as a frenchdoor laminoplasty discusses the. Clinical application of a new plate fixation system in open. The surgeon creates hinges on both sides of the lamina. The procedure also is referred to as an open door laminoplasty because it involves hinging one side of the posterior elements of the vertebrae and cutting the other side so that it forms a door which is then opened and held in place with wedges made of bone and instrumentation. Instruments and implants approved by the ao foundation. Jun 14, 2016 hirabayashi then introduced the opendoor laminoplasty technique in 1977, followed by the kurokawa doublehinge, or french door technique in 1980. The double door laminoplasty creates an opening in the midline of the spinous processes and a symmetrical expansion with hinges on both laminae. Conclusion although open door and french door laminoplasty were found to be effective for treating cervical compressive myelopathy, the open door technique seems to be superior with respect to. Expansive opendoor laminoplasty secured with titanium. Laminoplasty medical clinical policy bulletins aetna. At present, the surgical methods of cervical laminoplasty are classified into two types, namely open door laminoplasty odl and french door laminoplasty fdl.
However, one acknowledged complication is springback complication or closure of the door which may result in restenosis of cervical canal and neurologic deterioration. Laminectomy and laminoplasty are popularly used in posterior cervical spine surgery but still have involved complications. Single and doubledoor laminoplasty techniques have been. Two types of laminoplasty for cervical spondylotic. Since cervical laminoplasty was first introduced by oyama and moriwaki with the name of expansive zlaminoplasty in 1972, various types of cervical laminoplasty have been developed.
Expansive open door laminoplasty is used widely for the treatment of cervical spondylosis and ossification of the posterior longitudinal ligament opll. The bone flap is then propped open using small wedges or pieces of bone such that the. Aug 24, 2012 another postsurgical complication related to cervical laminoplasty is c5 nerve root palsy. Surgical technique this publication is not intended for distribution in the usa. At present, few reports are comparing these 2 major cervical posterior laminoplasty methods with opendoor and frenchdoor laminoplasty in terms of neurological recovery, cervical alignment, and surgical complications. Cervical laminoplasty is a spinal surgery treatment that involves cutting the part of the vertebrae that covers the spinal canal in an effort to relieve pressure on the spinal cord.
The two lateral hinges opened the cervical canal like a frenchdoor with plastic. Unilateral subaxial approach with detachment of muscles only on one side. P osterior cervical surgery open door laminoplasty cervical posterior surgery depicts an open door laminoplasty procedure. Opendoor laminoplasty, or cervical laminoplasty, describes a technique in which the surgeon decompresses the spinal cord while retaining structural support for the vertebral column. Laminar z plasty was devised by hattori in 1971, reported by oyama in 1973 11, and subsequently modified by tomimura and watanabe in 1984 and 1987, respectively. The study aimed for addressing our cervical opendoor laminoplasty technique with sutures and bone grafts and subsequently the. In cases of opendoor laminoplasty, postoperative cervical alignment became more kyphotic and cervical range of motion was more restricted than that in. Another postsurgical complication related to cervical laminoplasty is c5 nerve root palsy. Noguchi h, koda m, funayama t, kumagai h, saito j, mannoji c, et al.
We have developed a unique modification of the surgical procedure to keep the lamina expanded, with the aim of preventing reclosure of the vertebral arch. For patients with spinal canal stenosis in the upper cervical spine who undergo c37 laminoplasty alone, it remains impossible to achieve full decompression due to its limited range. However, differences in outcome between the approaches remain unknown. Laminoplasty spinal surgery treatment virginia spine institute. Hirabayashi et al1 introduced unilateral open door laminoplasty, which has been widely used worldwide. Materials and methods a series of 25 consecutive myelopathic patients were treated with a novel instrumented cervical frenchdoor laminoplasty technique, whereby the enlarged posterior arch was held open with maxillofacial plates and screws. The flap of the laminae is kept open with a suture that is fixed to the facet capsule. Cervical open door laminoplasty c3, c4, c5, c6 medical. All the steps of the procedure are shown including. The laminae are then hinged open like a door, allowing the cord precious extra millimeters of space. Download scientific diagram schematic drawing depicting kims. Doubledoor laminoplasty also known as french door, spinous processsplitting, midline opening, or tsaw laminoplasty in hirabayashis expansive opendoor laminoplasty, the spinal cord is decompressed asymmetrically since the door opens on one side and hinges on the other. Jan 28, 2015 expansive opendoor laminoplasty is widely accepted as a reliable procedure for cervical myelopathy. Cervical opendoor laminoplasty technique with simple.
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