Clinical application of laminoplasty in spinal cord and spine surgery with double Y-shaped titanium plate internal fixation combined with posterior ligament complex replantation
Rong Xiaoci
Xiao Zongyu
Huang Yulun
Li Xuetao
Shao Jie
Zhu Haiping
Wang Zhimin
Abstract：Objective To explore the application of laminoplasty with double Y-shaped internal fixation titanium plate internal fixation combined with posterior ligament complex(PLC)replantation in spinal cord surgery.Methods A retrospective analysis was conducted on the clinical data of 6 patients with spinal cord diseases who underwent spinal cord surgery.These patients were underwent surgery using the technology of double Y-shaped titanium plate internal fixation combined with PLC replantation to reconstruct the spinal canal.All patients were followed up for 3-12 months after surgery,and spinal spiral CT three-dimensional reconstruction and spinal MRI examination were performed after surgery.Clinical symptoms were assessed using the modified McCormick grading standard,and neurological function was evaluated by Japanese Orthopedic Association Spinal Cord Function Score(IJOA score).The grading and scoring at the last follow-up were compared with those before surgery.The White&Panjabi spinal instability scoring standard was used to evaluate the stability of the spine after surgery.The transverse and anteroposterior diameters of each segment of the spinal canal with double Y-shaped titanium plate internal fixation combined with PLC replantation were measured before and after surgery to evaluate whether there was spinal stenosis after surgery.Results In 6 cases,there were 1-8 segments of free lamina,with an average of 4.0±2.9 segments.A total of 24 spinal canal segments were operated on.Among them,23 spinal canal segments were fixed,including 15 segments were fixed using double Y-shaped micro titanium plates,and 8 segments were fixed using two hole micro titanium plates.Except for 1 case had Class I Grade B incision healing,all other patients had a Class I Class A incision healing without infection,no local fluid accumulation,cerebrospinal fluid leakage,and no other complications such as spinal cord or nerve root injury caused by the technique were recorded.Postoperative CT scan showed good fixation of the micro titanium plate,without collapsing,displacement,or plate breakage,and no kyphosis or scoliosis of the spinal canal.The 6 patients were followed up for an average time of(8±4.1)months(3-12 months).Prior to surgery,there were 5 cases with McCormick grade Ⅱ,1 case with grade Ⅲ.At the last follow-up,there were 3 cases with McCormick grade I,1 case with grade Ⅱ,1 case with grade Ⅲ and 1 case with grade Ⅳ.Compared with preoperative results,clinical symptoms improved in 3 cases,remained unchanged in 1,and deteriorated in 2.The last follow-up of the IJOA score increased to(17.67±2.58)points,and compared with the preoperative score(16.33±1.97),the difference was statistically significant(t=-4,P=0.01).At the last follow-up,all 6 patients had postoperative White&Panjabi spinal instability scores<5,and no one experienced spinal instability.There was no statistically significant difference in the transverse and anterior posterior diameters of the spinal canal between the 15 segments fixed with double Y-shaped titanium plates after surgery and before surgery(all P>0.05).Conclusions In spinal cord surgery,the technology of double Y-shaped titanium plate internal fixation combined with PLC replantation is efficient to reconstruct the spinal canal with advantages,such as improved neurological function,fewer complications,and no spinal instability or spinal stenosis after surgery.
Keywords：spinal canal stenosislaminoplastydouble Y-shaped titanium plateposterior ligament complexspinal stability
Publication Date：2023-12-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 140-145 )