Opendoor laminoplasty odl and frenchdoor laminoplasty fdl are used to treat cervical multilevel compressive myelopathy. Regenos spacers are not suitable for open door laminoplasty because of serious adverse events caused by their insufficient mechanical strength. 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. 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. The laminae are then hinged open like a door, allowing the cord precious extra millimeters of space.
The surgeon uses a spacer made out of bone, metal or plastic, which is inserted to keep the spinal canal open. Open door laminoplasty odl and french door laminoplasty fdl are used to treat cervical multilevel compressive myelopathy. The part of the vertebrae that is cut is called the lamina. Clinical application of a new plate fixation system in open. Efficacy of modified expansive opendoor laminoplasty for. 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. Hirabayashi then introduced the opendoor laminoplasty technique in 1977, followed by the kurokawa doublehinge, or french door technique in 1980. Opendoor versus frenchdoor laminoplasty for the treatment. Laminectomy and laminoplasty are popularly used in posterior cervical spine surgery but still have involved complications. The doubledoor laminoplasty creates an opening in the midline of the spinous processes and a symmetrical expansion with hinges on both laminae. Clinical outcomes following cervical laminoplasty for 19. What is open door laminoplasty, and how should i code for it. Hirabayashi k 1978 expansive opendoor laminoplasty for cervical spondylotic myelopathy, in japanese shujutsu 32.
Single and doubledoor laminoplasty techniques have been. P osterior cervical surgery open door laminoplasty cervical posterior surgery depicts an open door laminoplasty procedure. This technique allows c5 fo raminotomy on both sides. Comparative effectiveness of opendoor laminoplasty versus frenchdoor laminoplasty in cervical compressive myelopathy. Cervical open door laminoplasty c3, c4, c5, c6 cervical spine animation depicts an open door laminoplasty to relieve spinal stenosis decompression. 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.
At present, the surgical methods of cervical laminoplasty are classified into two types, namely open door laminoplasty odl and french door laminoplasty fdl. At present, the surgical methods of cervical laminoplasty are broadly divided into two types from the viewpoint of the site of osteotomy. Clinical recovery after 5 level of posterior decompression spine. Two types of laminoplasty for cervical spondylotic. Expansive open door laminoplasty is widely accepted as a reliable procedure for cervical myelopathy.
Hirabayashi et al1 introduced unilateral open door laminoplasty, which has been widely used worldwide. The flap of the laminae is kept open with a suture that is fixed to the facet capsule. The laminae are then lifted to increase space in the spinal canal. B and d, axial and posterior view of opening of the laminoplasty door and closure of.
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. Another postsurgical complication related to cervical laminoplasty is c5 nerve root palsy. 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. Jun 14, 2016 hirabayashi then introduced the opendoor laminoplasty technique in 1977, followed by the kurokawa doublehinge, or french door technique in 1980. This study aims to determine comparative effectiveness and. In the classic open door laminoplasty technique, the lamina door is tethered open. 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. Comparative effectiveness of opendoor laminoplasty vs. Laminoplasty is performed to treat spinal stenosis in the neck or low back and may also act as a method to access underlying spinal disease such as a spinal tumor or syringomyelia, a spinal cord cyst.
Laminoplasty spinal surgery treatment virginia spine. Cervical open door laminoplasty c3, c4, c5, c6 medical. Opendoor cervical laminoplasty was originally developed in japan by hirabayashi for the treatment of multilevel cervical spondylotic myelopathy csm 4, 15. Expansive opendoor laminoplasty for cervical spondylotic myelopathy. Clinical application of a new plate fixation system in. Open door laminoplasty is an alternative treatment for spinal stenosis 723. The choice of frenchdoor laminoplasty or opendoor laminoplasty was. Clinical outcome and safety study of a newly developed.
The study aimed for addressing our cervical opendoor laminoplasty technique with sutures. Laminoplasty is a motion preserving surgery, meaning that no fusion is performed, and motion is not changed. Opendoor laminoplasty is an alternative treatment for spinal stenosis 723. Pdf clinical outcomes following cervical laminoplasty for. The surgeon cuts through the lamina on one side of the spinous process at.
Expansive opendoor laminoplasty is widely accepted as a reliable procedure for cervical myelopathy. Expansive opendoor laminoplasty also known as the hirabayashi, openhinged, or singledoor technique hirabayashi et al. Noguchi h, koda m, funayama t, kumagai h, saito j, mannoji c, et al. 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. 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. Degenerative cervical myelopathy due to multilevel subaxial spinal canal stenosis. Oot french door laminoplasty for cervical spondylotic. 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. 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. The bone flap is then propped open using small wedges or pieces of bone such that the. Opendoor cervical expansile laminoplasty neurosurgery. Opendoor laminoplasty, or cervical laminoplasty, describes a technique in which the surgeon decompresses the spinal cord while retaining structural support for the vertebral column. During a cervical laminoplasty, the posterior muscles are detached and small cuts are made in the posterior cervical laminae.
There are many variations of laminoplasty, such as en bloc, opendoor, and doubledoor also know as french door. Laminoplasty medical clinical policy bulletins aetna. The pressure on the spinal cord can be due to a variety of reasons, including a herniated or fractured disc, degeneration, or arthritis. 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. The goal of laminoplasty is to reposition the laminae to expand the spinal canal, allowing the spinal cord to migrate posteriorly. 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.
Several types of laminoplasty exist such as z plasty, opendoor laminoplasty, and frenchdoor laminoplasty with variable modifications. Expansive open door laminoplasty for cervical spondylotic myelopathy. All the steps of the procedure are shown including. The two lateral hinges opened the cervical canal like a frenchdoor with plastic. In the french door laminoplasty, the door is opened in the midline and thus creates a symmetric opening of the canal 32. 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. 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. Double door french door cervical laminoplasty openoperatingtheatre. Several types of laminoplasty exist such as z plasty, open door laminoplasty, and french door laminoplasty with variable modifications. Open door laminoplasty international journal of spine. Both eolp and frenchdoor laminoplasty became popular, and multiple subtypes of these operations were developed 9. Double door french door cervical laminoplasty youtube. Objectives expansive opendoor laminoplasty eolp is effective for multilevel cervical.
To investigate treatment differences, we performed a. Jan 28, 2015 expansive opendoor laminoplasty is widely accepted as a reliable procedure for cervical myelopathy. Jan 23, 2018 the study aimed for addressing our cervical open door laminoplasty technique with sutures and bone grafts and subsequently the followup outcomes. 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. Aug 08, 2018 ken is an active individual who owns his own business and takes pride in staying physically fit.
This manuscript demonstrates a doubledoor laminoplasty otherwise known as a frenchdoor laminoplasty discusses the. In cases of opendoor laminoplasty, postoperative cervical alignment became more kyphotic and cervical range of motion was more restricted than that in. Clinical indicators of surgical outcomes after cervical single opendoor laminoplasty assessed by the japanese orthopaedic association cervical myelopathy. However, one acknowledged complication is springback complication or closure of the door which may result in restenosis of cervical canal and neurologic deterioration. Pdf expansive opendoor laminoplasty secured with titanium. Aug 24, 2012 another postsurgical complication related to cervical laminoplasty is c5 nerve root palsy. The authors themselves acknowledge that there are many different laminoplasty techniques involved in these studies.
Cervical opendoor laminoplasty technique with simple sutures. Comparative effectiveness and functional outcome of open. The study aimed for addressing our cervical opendoor laminoplasty technique with sutures and bone grafts and subsequently the. Download scientific diagram schematic drawing depicting kims. Laminoplasty is an orthopaedicneurosurgical surgical procedure for treating spinal stenosis by. Open operating theatre is a proud partner of the new online postgraduate educational platform eccelearning. Expansive opendoor laminoplasty secured with titanium miniplates. Comparative effectiveness and functional outcome of opendoor. Bone graft or metal plates are often placed along the opening to maintain their open position. When debilitating neck pain affected his work and home life he met with university orthopedics. 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. This is known as an open door laminoplasty because the position of the bone resembles a door being held open by a doorstop. Opendoor laminoplasty had significantly reduced cervical range of motion than. Opendoor cervical laminoplasty with preservation of.
Clinical indicators of surgical outcomes after cervical. At present, the surgical methods of cervical laminoplasty are classified into two types, namely opendoor laminoplasty odl and frenchdoor laminoplasty fdl. Expansive opendoor laminoplasty secured with titanium. Expansive opendoor laminoplasty is used widely for the treatment of cervical spondylosis and ossification of the posterior longitudinal ligament opll. Laminoplasty techniques for the treatment of multilevel. Two types of laminoplasty for cervical spondylotic myelopathy. The c2 to c7 laminae are drilled at the lateral borders of the laminae. Doubledoor laminoplasty also known as french door, spinous process splitting, midline opening, or tsaw laminoplasty. Influence of extending expansive opendoor laminoplasty to c1. The surgeon cuts through the lamina on one side of the spinous process at the affected levels and notches the.
Hirabayashi et al1 introduced unilateral opendoor laminoplasty, which has been widely used worldwide. This manuscript demonstrates a doubledoor laminoplasty otherwise known as a frenchdoor laminoplasty discusses the indications and. This essentially created an asymmetric expansion of the canal. French door laminoplasty in the opendoor expansive laminoplasty, the canal is opened on one side and hinged on the other. Regenos spacers are not suitable for opendoor laminoplasty because of serious adverse events caused by their insufficient mechanical strength.
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. We describe the technique of opendoor and frenchdoor cervical laminoplasty and present our clinical results. The surgeon creates hinges on both sides of the lamina. P osterior cervical surgery open door laminoplasty.
Comparison of laminoplasty versus laminectomy and fusion. Instruments and implants approved by the ao foundation. However, differences in outcome between the approaches remain unknown. 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 sagittal parameters. The double door laminoplasty creates an opening in the midline of the spinous processes and a symmetrical expansion with hinges on both laminae. Influence of extending expansive opendoor laminoplasty to. In the doubledoor type, osteotomy is performed at the. What is opendoor laminoplasty, and how should i code for it. Unilateral subaxial approach with detachment of muscles only on one side. A new expansive twoopendoors laminoplasty for multilevel. Laminoplasty techniques for the treatment of multilevel cervical.
In this technique, a hinge is created on one side of the laminaspinous processligamentum flavum complex. Expansive open door laminoplasty is used widely for the treatment of cervical spondylosis and ossification of the posterior longitudinal ligament opll. Expansive opendoor laminoplasty secured with titanium miniplates is a good surgical method for multiplelevel cervical stenosis. Comparative effectiveness of open door laminoplasty versus french door laminoplasty in cervical compressive myelopathy. 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. The impetus for this new procedure was based on three surgical problems.
Surgical technique this publication is not intended for distribution in the usa. Moreover, most of the research has not been well designed. 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. One side of the bone is completely cut, while the other side acts as a hinge. Cervical kyphosis or instability, bilateral radiculopathy due to foraminal stenosis, involvement of c2 or c7. In the classic opendoor laminoplasty technique, the lamina door is tethered open. 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. Laminoplasty spinal surgery treatment virginia spine institute. Fujimura y, nishi y, nakamura m 1997 dorsal shift and expansion of the spinal cord after expansive opendoor laminoplasty. Comparison of laminoplasty versus laminectomy and fusion in. Nakashima h, kato f, yukawa y et al 2014 comparative effectiveness of opendoor laminoplasty versus frenchdoor laminoplasty in cervical compressive myelopathy. 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. A new expansive twoopendoors laminoplasty for multilevel cervical spondylotic myelopathy.
We describe the technique of open door and french door cervical laminoplasty and present our clinical results. Cervical opendoor laminoplasty technique with simple. Expansive opendoor laminoplasty versus laminectomy and instrumented fusion for cases with cervical ossification of the posterior longitudinal ligament and straight lordosis. 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. Expansive laminoplasty has gradually become a preferred procedure for almost all patients with cervical spondylotic myelopathy with multilevel spinal stenosis. 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. 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.