Overview
A simple method of thoracic laminoplasty using spinous processes is described. The procedure involves reshaping the spinous processes which have been removed during laminectomy and suturing these back into position to provide a cover for the dura. The procedure was carried out in five patients with good results. Laminoplasty using spinous processes appears to be a simple and safe alternative, using otherwise discarded tissue and requiring no sophisticated instrumentation, prosthetic material, or technically complex maneuvers.
Results
The morphometric study in control individuals revealed that the safe trajectories for simulated screws measured 25–30 mm in length and 8–11 mm in diameter in the thoracic region (T1–12) and 26–34 mm in length and 6–7 mm in diameter in the lumbosacral region (L1–S1). This morphometric and simulation study showed that translaminar screw placement would be possible in practice.
Five patients underwent en bloc laminoplasty and translaminar screw fixation in which the screws measured 2.7 mm in diameter and 24 or 26 mm in length. Sixteen attempts at translaminar fixation were made in 8 vertebrae. Fourteen translaminar screws were successfully placed at the thoracic and lumbar levels. Two microplates had to be used because the laminae were too thin and narrow after further laminectomy with undercutting. There were no complications associated with the translaminar screws.
The mean follow-up period was 14.5 months. There was no screw breakage or displacement. Solid osseous fusion was documented in 2 patients who underwent CT scanning 15 months postoperatively.
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