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Expansive Open-Door Laminoplasty

  • Chiba Kazuhiro
  • Maruiwa Hirofumi
  • Matsumoto Morio
  • Hirabayashi Kiyoshi
  • Toyama Yoshiaki
Chapter

Abstract

Until 1968, when Kirita [1] devised a sophisticated technique for extensive laminectomy in which the laminae were thinned and divided at the midline with a high-speed drill, both patients and surgeons had suffered from unpredictable results with conventional laminectomy. Being both safe and effective, Kirita’s technique brought remarkable progress in the surgical results of cervical compressive myelopathy. However, problems such as postoperative kyphosis, the vulnerability of the unprotected spinal cord, and the formation of a laminectomy membrane remained unsolved problems [2]. To address these problems, in 1973, Hattori and co-workers devised an expansive Z-laminoplasty in which the spinal canal was totally reconstructed with preservation of the posterior protective structures [3,4]. However, this technique did not gain widespread acceptance because it was too technically demanding as well as time-consuming. Hirabayashi et al. [5] modified Kirita’s method and decompressed the spinal cord by making bony gutters in both sides of the lamina followed by en-bloc resection of the laminae. The idea of open-door laminoplasty evolved when Hirabayashi [6] noted that pulsation of the dural tube occurred when he lifted one side of the laminae, indicating that sufficient decompression was obtained even before total resection of the laminae. He performed the first case of this procedure in 1977, and named it expansive open-door laminoplasty (ELAP; eelap). Since then, more than 500 patients have undergone this procedure at Keio University Hospital and affiliated hospitals with favorable results.

Keywords

Spinous Process Cervical Spondylotic Myelopathy Cervical Myelopathy Cervical Lordosis Spinal Canal Stenosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Kirita Y (1976) Posterior decompression for cervical spondylosis and OPLL. (in Japanese) Shujutsu 30:287–302Google Scholar
  2. 2.
    Cattell HS, Clark GL (1967) Cervical kyphosis and instability following multiple laminectomies in children. J Bone Joint Surg 49A:713–721Google Scholar
  3. 3.
    Kawai S, Sunago K, Doi K, et al. (1988) Cervical laminoplasty (Hattori’s method). Procedure and follow-up results. Spine 13:1245–1250PubMedCrossRefGoogle Scholar
  4. 4.
    Ohyama M, Hattori S, Moriwaki N, et al. (1973) A new method of cervical laminectomy. (in Japanese) Chubu Nippon Siekeigeka Gakkai Zasshi 16:792–794Google Scholar
  5. 5.
    Hirabayashi K, Toyama Y, Chiba K (1999) Expansive laminoplasty for myelopathy in ossification of the longitudinal ligament. Clin Orthop 1359:35–48Google Scholar
  6. 6.
    Hirabayashi K (1978) Expansive open-door laminoplasty for cervical spondylotic myelopathy, (in Japanese) Shujutsu 32:1159–1163Google Scholar
  7. 7.
    Fujimura Y, Nishi Y, Nakamura M (1997) Dorsal shift and expansion of the spinal cord after expansive open-door laminoplasty. J Spinal Disord 10:282–287PubMedCrossRefGoogle Scholar
  8. 8.
    Herkowitz HN (1988) Cervical laminaplasty: its role in the treatment of cervical radiculopathy. J Spinal Disord 1:179–188PubMedCrossRefGoogle Scholar
  9. 9.
    Norwinski GP, Visarius H, Nolte LP, et al. (1993) A biomechanical comparison of cervical laminaplasty and cervical laminectomy with progressive facetectomy. Spine 18:1995–2004CrossRefGoogle Scholar
  10. 10.
    Yonenobu K, Hosono N, Iwasaki M, et al. (1992) Laminoplasty versus subtotal corpectomy. A comparative study of results in multisegmental cervical spondylotic myelopathy. Spine 17:1281–1284PubMedCrossRefGoogle Scholar
  11. 11.
    Baba H, Furusawa N, Imura S, et al. (1994) Laminoplasty following anterior cervical fusion for spondylotic myeloradiculopathy. Int Orthop 18:1–5PubMedGoogle Scholar
  12. 12.
    Hirabayashi K (1994) Expansive open-door laminoplasty. In: Sherk HH, Dunn EJ, Eismont FJ (eds) The cervical spine. An atlas of surgical procedures. Lippincott, Philadelphia, pp 233–250Google Scholar
  13. 13.
    Herkowitz HN (1988) A comparison of anterior cervical fusion, cervical laminectomy, and cervical laminoplasty for the surgical management of multiple level spondylotic radiculopathy. Spine 13:774–780PubMedCrossRefGoogle Scholar
  14. 14.
    Satomi K, Nishi Y, Kohno T, et al. (1994) Long-term follow-up studies of open-door expansive laminoplasty for cervical stenotic myelopathy. Spine 19:507–510PubMedCrossRefGoogle Scholar
  15. 15.
    Iwasaki M, Ebara S, Miyamoto S, et al. (1996) Expansive laminoplasty for cervical radiculomyelopathy due to soft disc herniation. Spine 21:32–38PubMedCrossRefGoogle Scholar
  16. 16.
    Yonenobu K, Fuji T, Ono K, et al. (1985) Choice of surgical treatment for multisegmental cervical spondylotic myelopathy. Spine 10:710–716PubMedCrossRefGoogle Scholar
  17. 17.
    Shinomiya K, Okamoto A, Kamikozuru M, et al. (1993) An analysis of failures in primary cervical anterior spinal cord decompression and fusion. J Spinal Disord 6: 277–288PubMedCrossRefGoogle Scholar
  18. 18.
    Hirabayashi K, Watanabe K, Wakano K, et al. (1983) Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine 8:693–699PubMedCrossRefGoogle Scholar
  19. 19.
    Toyama Y, Hirabayashi H, Kamata M, et al. (1997) Long-term clinical results of anterior interbody fusion for cervical spondylotic myelopathy,(in Japanese) J East Jpn Orthop Traumatol 9:487–492Google Scholar
  20. 20.
    Hirabayashi K, Toyama Y (1997) Choice of surgical procedure for cervical ossification of the posterior longitudinal ligaments. In: Yonenobu K, Sakou T, Ono K (eds) Ossification of the posterior longitudinal ligament. Springer, Tokyo, pp 135–142Google Scholar
  21. 21.
    Fujimura Y, Nishi Y, Chiba K, et al. (1998) Multiple regression analysis of the factors influencing the results of expansive open-door laminoplasty for cervical myelopathy due to ossification of the posterior longitudinal ligament. Arch Orthop Trauma Surg 117:471–474PubMedCrossRefGoogle Scholar
  22. 22.
    Hirabayashi K, Satomi K, Toyama Y (1998) Surgical management of OPLL: anterior versus posterior approach. Part II. In: The Cervical Spine Research Society Editorial Committee (eds) The cervical spine, 3rd edn. Lippincott-Raven, Philadelphia, pp 876–887Google Scholar
  23. 23.
    Baba H, Maezawa Y, Furusawa N, et al. (1995) Flexibility and alignment of the cervical spine after laminoplasty for spondylotic myelopathy. A radiographic study. Int Orthop 19:116–121PubMedGoogle Scholar
  24. 24.
    Maruiwa H, Chiba K, Watanabe M, et al. (2000) Long-term results of expansive open-door laminoplasty for cervical spondylotic myelopathy, (in Japanese) Rinsho Seikeigeka 35:411–416Google Scholar
  25. 25.
    Maruiwa H, Kamata M, Watanabe M, et al. (2000) Long-term results of expansive open-door laminoplasty for ossification of the longitudinal ligament, (in Japanese) J Jpn Orthop Assoc 74:S690Google Scholar
  26. 26.
    Baba H, Uchida K, Maezawa Y, et al. (1996) Lordotic alignment and posterior migration of the spinal cord following en bloc open-door laminoplasty for cervical myelopathy: a magnetic resonance imaging study. J Neurol 243:626–632PubMedCrossRefGoogle Scholar
  27. 27.
    Kimura I, Shingu H, Nasu Y (1995) Long-term follow-up of cervical spondylotic myelopathy treated by canal-expansive laminoplasty. J Bone Joint Surg Br 77:956–961PubMedGoogle Scholar
  28. 28.
    Kohno K, Kumon Y, Oka Y, et al. (1997) Evaluation of prognostic factors following expansive laminoplasty for cervical spinal stenotic myelopathy. Surg Neurol 48: 237–245PubMedCrossRefGoogle Scholar
  29. 29.
    Chiba K, Toyama Y, Watanabe M, et al. (2000) Impact of longitudinal distance of the cervical spine on the results of expansive open-door laminoplasty. Spine 25: 2893–2898PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 2003

Authors and Affiliations

  • Chiba Kazuhiro
    • 1
  • Maruiwa Hirofumi
    • 1
  • Matsumoto Morio
    • 1
  • Hirabayashi Kiyoshi
    • 1
  • Toyama Yoshiaki
    • 1
  1. 1.Department of Orthop aedic SurgerySchool of Medicine, Keio UniversityShinjuku-ku, TokyoJapan

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