Minimally invasive cervical expansile laminoplasty: An initial cadaveric study

Michael Y. Wang, Barth A. Green, Ernesto Coscarella, Mustafa K. Baskaya, Allan D.O. Levi, James D. Guest, Edward C. Benzel, Mark N. Hadley, Michael G. Kaiser, Paul C. McCormick

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

OBJECTIVE: Expansile laminoplasty has been successfully used to treat cervical myelopathy attributable to canal stenosis. However, detachment of the posterior cervical muscles is thought to contribute to postoperative axial neck pain and kyphosis. Minimizing the amount of muscular dissection might reduce the likelihood of these sequelae. METHODS: Six human cadaveric spines were used to assess the feasibility of a minimally invasive laminoplasty technique. A 22-mm tubular dilator port was used to access the lamina-facet junctions from C2 to C7, through bilateral stab incisions at C4-C5 and C5-C6. Troughs at the lamina-facet junctions were drilled bilaterally, and the contiguous laminae were lifted en bloc from one side. Ten-millimeter rib allograft spacers were inserted to maintain a gap on the open side. RESULTS: Exposure of six cervical levels was easily accomplished with two small incisions on each side. Drilling was achieved without dural violations. The midsagittal spinal canal diameter was increased by a mean of 38% and the spinal canal area was increased by an average of 43% at the level of C5. CONCLUSION: A minimally invasive approach for cervical laminoplasty could be performed in human cadavers. The measured increases in spinal canal space approximated those demonstrated to be associated with stabilization or improvement of neurological status.

Original languageEnglish (US)
Pages (from-to)370-373
Number of pages4
JournalNeurosurgery
Volume52
Issue number2
DOIs
StatePublished - Feb 1 2003

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Keywords

  • Cervical spine
  • Laminoplasty
  • Minimally invasive surgery
  • Myelopathy

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Wang, M. Y., Green, B. A., Coscarella, E., Baskaya, M. K., Levi, A. D. O., Guest, J. D., Benzel, E. C., Hadley, M. N., Kaiser, M. G., & McCormick, P. C. (2003). Minimally invasive cervical expansile laminoplasty: An initial cadaveric study. Neurosurgery, 52(2), 370-373. https://doi.org/10.1227/01.NEU.0000043933.32287.EE