Abstract
OBJECTIVE Cervical open-door laminoplasty (ODL) is designed to decompress the spinal cord, maintain motion, and prevent postlaminectomy kyphosis. Many traditional laminoplasty techniques involve disruption of the posterior ligamentous structures, most notably the C7-T1 supraspinous ligament and interspinales muscle complex (intraspinous and supraspinous ligaments [ISLs]). METHODS Eight human cervical cadaveric specimens (C2-T1) were used to investigate the subaxial kinematics following ODL with varying degrees of posterior element disruption. Ligamentous integrity was preserved and specimens were tested utilizing force control in flexion-extension (FE), lateral bending (LB), and axial rotation (AR) in the native state, and following 1) C3-7 ODL, 2) ODL with terminal ISL resection, 3) ODL with C3-7 spinous process resection, and 4) C3-7 laminectomy. Range of motion (ROM) was measured across C2-T1, "global," and at the segmental level. RESULTS Compared with ODL, sectioning the terminal ISLs resulted in global ROM increases by 7.9% in FE, 2.4% in LB, and 5.6% in AR (p > 0.05), whereas laminectomy increased global ROM by 36.0% in FE (p = 0.002) and a 26.3% increase in AR ROM (p = 0.01). When considering segmental ROM, resection of ...Continue Reading
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