The purpose of this retrospective clinical series was to evaluate the benefits and complications of plate fixation for open-door laminoplasty in cervical spondylotic myelopathy with multilevel spinal stenosis compared with open-door laminoplasty without fixation. Forty-nine patients underwent open-door laminoplasty for cervical myelopathy with multilevel spinal stenosis with at least 13 months of follow-up. A plate was used as the sole method of fixation between the lateral mass and lamina with 3 screws. Computed tomography scans obtained pre- and postoperatively were assessed for plate complications and spinal canal enlargement. Pre- and postoperative neurological condition was assessed by the Japanese Orthopedic Association (JOA) myelopathy score. Overall cervical spine range of motion (ROM) was measured in full flexion and extension radiographs pre- and postoperatively. No restenosis due to door reclosure was noted, and no plates failed. No screws were backed out or broken. Almost all patients showed neurological improvement. The JOA score increased by 3.9±0.7 points in the suture group and 4.3±0.8 points in the plate group (P>.05). The postoperative increase in mean anteroposterior diameter of the spinal canal from C3 to C7 was 4.5±0.6 mm in the suture group and 5.1±0.5 mm in the plate group. The greater mean anteroposterior diameter increase in the plate group was statistically significant (P .05). No difference in axial symptoms was found between the 2 groups.

/pdf/clinical-application-of-a-new-plate-fixation-system-in-open-d5tz4s60lm.pdf

Clinical application of a new plate fixation system in open-door laminoplasty.

Is Mini-Plate Fixation Superior to Suture Suspensory Fixation in Cervical Laminoplasty? A Meta-Analysis

STUDY DESIGN: A cadaveric study. OBJECTIVE: To determine whether the use of suture anchors is warranted in cervical laminoplasty. SUMMARY OF BACKGROUND DATA: The use of suture anchors to stabilize elevated laminae has been popularized in laminoplasty. However, the validity of using suture anchors in laminoplasty has not been determined. METHODS: Six intact fresh frozen cadavers were used. Open-door laminoplasty with a hinge on the cadaver's left side was performed on levels C3-C7. Elevated laminae were stabilized by suture anchors equipped with strain gauges, which were placed on C3, C5, and C7 left lateral masses. After surgery, the cervical spine was manually loaded passively, and the mechanical loads on each suture anchor during each motion were measured. Finally, the incision was opened again, and the failure loads of the suture anchors were also measured. RESULTS: After cervical loading, all elevated laminae were confirmed to be intact without dislodgement or failure of the suture anchors. The loads during left rotation and left bending were significantly higher than those during the respective motion to the right at all levels, except in rotation at C3. The loads on the C5 anchors in flexion and left rotation and on the C7 anchors in extension were relatively high. The maximum load obtained in the present study was 14.9 N, which was one order of magnitude lower than the mean failure load of the suture anchors (131.7 N). CONCLUSION: Biomechanical laterality was demonstrated, reflecting the asymmetrical nature of open-door laminoplasty. The maximum load on the suture anchors was much lower than the failure load and was consistent with the stability of the suture anchors encountered in clinical cases. This may support the validity of using suture anchors in laminoplasty, although the loads during active motion may be higher than our results. LEVEL OF EVIDENCE: N/A.

Biomechanical evaluation of the suture anchors used in open-door laminoplasty: a cadaveric study.

Comparison of single versus double door posterior cervical laminoplasty for patients with cervical spondylotic myelopathy: A systematic review and meta-analysis.

Efficacy and Safety of One-Stage Selective Discectomy Combined with Expansive Hemilaminectomy in the Treatment of Cervical Spondylotic Myelopathy

Open-door laminoplasty is a commonly performed procedure for the treatment of multiple level cervical spinal stenosis. One complication of this procedure is closure of the hinge and subsequent restenosis. Twinfix suture anchor was used in laminoplasty to stabilize cervical canal expansion. 53 patients with multiple level cervical spinal stenosis underwent laminoplasty. A unilateral open-door technique was performed for the lesion level and the elevated lamina was fixed to the lateral mass using Twinfix suture anchors. Radiography, magnetic resonance imaging, and computed tomography (CT) scanning were used for imaging studies. The Japanese Orthopedic Association score was adopted to compare clinical outcome before and after surgery. None of 53 patients who had the door secured with Twinfix suture anchors had closure of the hinge. Additionally, the suture anchors maintained their position without loosening or “pull-outs” on postoperative follow-up radiographs. The Japanese Orthopedic Association score increased significantly from 8.5 ± 3.2 before surgery to 14.2 ± 1.36 at final follow-up. Postoperative radiography and CT scan demonstrated significantly increased anteroposterior diameter of the spinal canal. There were four short-term complications: two were small dural-tears which were repaired intraoperatively without further sequelae, and the other 2 were both epidural hematomas that required emergent return to the operating room for evacuation. There were no Twinfix suture anchor-related complications. This Twinfix suture anchor can provide a firm and secure anchor for elevated open laminae in laminoplasty.

/pdf/laminoplasty-using-twinfix-suture-anchors-to-maintain-2ppakquwlb.pdf

Laminoplasty using Twinfix suture anchors to maintain cervical canal expansion

Birth asphyxia causes hypoxia or inadequate perfusion to the organs of newborns, leading to metabolism dysfunctions including blood glucose disorders.Neonates with and without birth asphyxia were retrospectively recruited from 53 hospitals in Hubei Province from January 1 to December 31, 2018. In summary, 875, 1139, and 180 cases in the control group, the mild asphyxia group, and the severe asphyxia group were recruited, respectively. Neonatal blood glucose values at postnatal 1, 2, 6, and 12 h (time error within 0.5 h was allowed) were gathered from the medical records.The incidence rates of hyperglycemia in the control group, the mild asphyxia group and the severe asphyxia group were 2.97%, 7.90%, and 23.33%, respectively (p < 0.001). Additionally, the incidence rates of hypoglycemia in the three groups above were 3.66%, 4.13%, and 7.78%, respectively (p = 0.042). The blood glucose values of neonates with hypoglycemia in the asphyxia group were lower than in the control group (p = 0.003). Furthermore, the blood glucose values of neonates with hyperglycemia were highest in the severe asphyxia group (p < 0.001). There were 778 and 117 cases with blood glucose records at four predefined time points in the mild and severe asphyxia group, respectively. The incidence of blood glucose disorders in the mild asphyxia group significantly decreased from postnatal 6 h (p＜0.05). However, we found no obvious changes of the incidence of glucose disorders within postnatal 12 h in the severe asphyxia group (p = 0.589).Birth asphyxia is likely to cause neonatal blood glucose disorders, both hypoglycemia and hyperglycemia, during the early postnatal life. The neonates with severe asphyxia have higher incidence, worse severity and longer duration of blood glucose disorders than neonates with mild asphyxia. 

Effect of birth asphyxia on neonatal blood glucose during the early postnatal life: A multi-center study in Hubei Province, China.

The utility model relates to the technical field of orthopaedic medical appliances and in particular relates to a combined bone grafting device generally used for spine interbody and vertebral body. The combined bone grafting device is made of stainless steel, so that the strength of the bone grafting device is enhanced, the reliability of the bone grafting device is improved, and the spinal surgery efficiency is improved. The bone grafting device comprises a handle, a funnel, a sleeve tube, a piston and an anti-leak sleeve tube, and is characterized in that the handle is connected with the piston; the funnel is in threaded fit with the sleeve tube; the piston penetrates through the funnel and is arranged in the sleeve tube; the anti-leak sleeve tube is arranged outside the sleeve tube.

Combined bone grafting device generally used for spine interbody and vertebral body

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Laminoplasty using Twinfix suture anchors to maintain cervical canal expansion

Effect of birth asphyxia on neonatal blood glucose during the early postnatal life: A multi-center study in Hubei Province, China.

Combined bone grafting device generally used for spine interbody and vertebral body