Posterior Cervical Laminoplasty Using a New Plating System: Technical Note

Background: Laminoplasty is well described in the Japanese literature as a surgical option for treating ossification of the posterior longitudinal ligament (OPLL). The open door technique has gained increasing popularity in the United States and Europe to treat not only OPLL but also cervical stenotic myelopathy. An obstacle to its widespread use is the lack of a suitable fixation plate to adequately secure the fractured lamina to the lateral mass. Our objective was to demonstrate the advantages of a novel miniplate (Ti-Mesh LP system; Medtronic Sofamor Danek, Memphis, TN, USA) that is ideally suited for fixing the lamina to the lateral mass. Methods: We used the Ti-Mesh LP miniplate system to perform laminoplasties on five patients, all male, with a mean preoperative Nurick score of 2.8. Four patients had congenital cervical stenosis with myelopathy and one had OPLL. Open door laminoplasties were performed on all patients. The plates were implanted with a claw positioned on the trapdoor lamina and a flat plate on the lateral mass. Results: The system was implanted successfully in all patients. The mean number of levels fixated was 4.4. There were no intraoperative or postoperative complications after >5 months follow-up. Conclusions: The new Ti-Mesh LP cranial miniplate and screw system facilitates posterior cervical laminoplasty procedures by eliminating the need to contour cranial miniplates for use in the cervical spine. Its unique claw construct and angled design are ideal for holding a trapdoor laminoplasty in the open position. We have used this system successfully and without complications to perform decompressive posterior cervical laminoplasties in five patients.