New Technique of Laminoplasty—Modified Hirabayashi with Lateral Mass Screwing and Spinous Process Wiring for Cervical Myelopathy

Abstract

Gold standard laminoplasty techniques of Kurokawa, Itoh have been realized in Vietnam since 1995 with good results. Some disadvantages of these techniques are found: large destruction of muscles, tip of spinous processes, supraspinous ligament, interspinatous ligaments, resection and re-insertion of C2 tip of spinous process; the tailed trapezoid iliac grafts are not always in satisfactory shape as good spacer in Kurokawa technique; the boneceram piece, quite expensive for Vietnamese patients, is not affordable for all patients; the Itoh technique demands a multi-level grafts with multiple silk wiring and it is not easy to make a hole in facet for silk anchorage. The suggested wiring of spinous tip to lateral mass screw is a simple technique as more stable modified Hirabayashi ELP with two weeks soft collar wearing. This prospective study was conducted to introduce the new modified Hirabayashi Extensive Open-door Laminoplasty (ELP) for Cervical Myelopathy (CM).