J Neurol Surg A Cent Eur Neurosurg 2024; 85(02): 171-181
DOI: 10.1055/s-0043-1769005
Review Article

Laminoplasty in Motion: Evolving Techniques and Complications

Ian M. Singleton
1   Department of Orthopaedic Surgery, St. Mary's Medical Center, San Francisco, California, United States
2   The Taylor Collaboration, San Francisco, California, United States
Ben Crawford
1   Department of Orthopaedic Surgery, St. Mary's Medical Center, San Francisco, California, United States
Ashish Mittal
1   Department of Orthopaedic Surgery, St. Mary's Medical Center, San Francisco, California, United States
Alexander A. Rosinski
1   Department of Orthopaedic Surgery, St. Mary's Medical Center, San Francisco, California, United States
Dimitriy G. Kondrashov
1   Department of Orthopaedic Surgery, St. Mary's Medical Center, San Francisco, California, United States
› Author Affiliations


Cervical laminoplasty is an increasingly popular surgical option for the treatment of cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL). Over the past few decades, there have been substantial developments in both surgical technique and hardware options. As the field of cervical surgery rapidly evolves, there is a timely need to reassess the evolving complications associated with newer techniques. This review aims to synthesize the available literature on cervical laminoplasty and associated mechanical complications pertaining to different laminoplasty hinge fixation options.

Publication History

Received: 10 September 2022

Accepted: 02 February 2023

Article published online:
28 July 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

  • References

  • 1 Nouri A, Tetreault L, Singh A, Karadimas SK, Fehlings MG. Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis. Spine 2015; 40 (12) E675-E693
  • 2 Davies BM, Mowforth OD, Smith EK, Kotter MRN. Degenerative cervical myelopathy. BMJ 2018; 360: k186
  • 3 Boogaarts HD, Bartels RHMA. Prevalence of cervical spondylotic myelopathy. Eur Spine J 2015; 24 (Suppl. 02) 139-141
  • 4 Ghogawala Z, Terrin N, Dunbar MR. et al. Effect of ventral vs dorsal spinal surgery on patient-reported physical functioning in patients with cervical spondylotic myelopathy: a randomized clinical trial. JAMA 2021; 325 (10) 942-951
  • 5 Cho SK, Kim JS, Overley SC, Merrill RK. Cervical laminoplasty: indications, surgical considerations, and clinical outcomes. J Am Acad Orthop Surg 2018; 26 (07) e142-e152
  • 6 Lau D, Winkler EA, Than KD, Chou D, Mummaneni PV. Laminoplasty versus laminectomy with posterior spinal fusion for multilevel cervical spondylotic myelopathy: influence of cervical alignment on outcomes. J Neurosurg Spine 2017; 27 (05) 508-517
  • 7 Mitsunaga LK, Klineberg EO, Gupta MC. Laminoplasty techniques for the treatment of multilevel cervical stenosis. Adv Orthop 2012; 2012: 307916
  • 8 Shiraishi T, Yato Y, Yoshida H, Abe T, Ikegami T. New double-door laminoplasty procedures to preserve the muscular attachments to the spinous processes including the axis. Eur J Orthop Surg Traumatol 2002; 12 (04) 175-180
  • 9 Kirita Y, Onomura T, Ogami H. et al. Application of partial laminectomy in neck-shoulder-hand syndrome. Nihon Seikeigeka Gakkai Zasshi 1964; 38 (06) 595-597
  • 10 Kurokawa R, Kim P. Cervical laminoplasty: the history and the future. Neurol Med Chir (Tokyo) 2015; 55 (07) 529-539
  • 11 Oyama M, Hattori S, Moriwaki N. A new method of posterior decompression. Chubuseisaisi 1973; 16: 792
  • 12 Kurokawa T. Double-door laminoplasty through longitudinal splitting of the spinous process for cervical spondylotic myelopathy. Rinsho Seikei Geka 1984; 19: 483-490
  • 13 Hirabayashi K, Watanabe K, Wakano K, Suzuki N, Satomi K, Ishii Y. Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine 1983; 8 (07) 693-699
  • 14 Hirabayashi K, Watanabe K. A review of my invention of expansive laminoplasty. Neurospine 2019; 16 (03) 379-382
  • 15 Kothe R, Schmeiser G, Papavero L. Open-door laminoplasty : what can the unilateral approach offer?. Oper Orthop Traumatol 2018; 30 (01) 3-12
  • 16 Hirabayashi S. Recent surgical methods of double-door laminoplasty of the cervical spine (Kurokawa's method). Spine Surg Relat Res 2018; 2 (02) 154-158
  • 17 Protopsaltis TS, Choi CE, Kaplan DJ. Double-door or “French-door” cervical laminoplasty. J Spinal Disord Tech 2015; 28 (09) 319-323
  • 18 Li XK, Liu X, Che L, Ma CJ, Samartzis D, Wang HQ. Cervical open-door laminoplasty technique with simple sutures and bone grafts: a single institutional study with 30 consecutive cases. J Orthop Surg Res 2015; 10: 14
  • 19 Matsumoto M, Watanabe K, Tsuji T. et al. Risk factors for closure of lamina after open-door laminoplasty. J Neurosurg Spine 2008; 9 (06) 530-537
  • 20 Hu W, Shen X, Sun T, Zhang X, Cui Z, Wan J. Laminar reclosure after single open-door laminoplasty using titanium miniplates versus suture anchors. Orthopedics 2014; 37 (01) e71-e78
  • 21 Wang HQ, Mak KC, Samartzis D. et al. “Spring-back” closure associated with open-door cervical laminoplasty. Spine J 2011; 11 (09) 832-838
  • 22 Lee JY, Hanks SE, Oxner W, Tannoury C, Donaldson III WF, Kang JD. Use of small suture anchors in cervical laminoplasty to maintain canal expansion: a technical note. J Spinal Disord Tech 2007; 20 (01) 33-35
  • 23 Fujishiro T, Nakano A, Baba I, Fukumoto S, Nakaya Y, Neo M. Double-door cervical laminoplasty with suture anchors: evaluation of the clinical performance of the constructs. Eur Spine J 2017; 26 (04) 1121-1128
  • 24 Yang SC, Niu CC, Chen WJ, Wu CH, Yu SW. Open-door laminoplasty for multilevel cervical spondylotic myelopathy: good outcome in 12 patients using suture anchor fixation. Acta Orthop 2008; 79 (01) 62-66
  • 25 Khan SN, Edmonds EW, Titelman RM, Gupta MC. Using suture anchors for cervical laminoplasty: a reliable, safe, and simple technique. Am J Orthop 2008; 37 (08) 400-402
  • 26 Kurokawa Y, Yokoyama Y, Kuroda K. et al. Biomechanical evaluation of the suture anchors used in open-door laminoplasty: a cadaveric study. Spine 2014; 39 (21) E1248-E1255
  • 27 Yu HL, Xiang LB, Liu J, Chen Y, Yu M, Cao Y. Laminoplasty using Twinfix suture anchors to maintain cervical canal expansion. Eur Spine J 2010; 19 (10) 1795-1798
  • 28 Miyata M, Neo M, Fujibayashi S, Takemoto M, Nakamura T. Double-door cervical laminoplasty with the use of suture anchors: technical note. J Spinal Disord Tech 2008; 21 (08) 575-578
  • 29 Jin SW, Kim SH, Kim BJ. et al. Modified open-door laminoplasty using hydroxyapatite spacers and miniplates. Korean J Spine 2014; 11 (03) 188-194
  • 30 Kubo S, Goel VK, Yang SJ, Tajima N. Biomechanical evaluation of cervical double-door laminoplasty using hydroxyapatite spacer. Spine 2003; 28 (03) 227-234
  • 31 Tanaka N, Nakanishi K, Kamei N. et al. Novel hybrid hydroxyapatite spacers ensure sufficient bone bonding in cervical laminoplasty. Asian Spine J 2018; 12 (06) 1078-1084
  • 32 Kimura A, Seichi A, Inoue H, Hoshino Y. Long-term results of double-door laminoplasty using hydroxyapatite spacers in patients with compressive cervical myelopathy. Eur Spine J 2011; 20 (09) 1560-1566
  • 33 Takayasu M, Takagi T, Nishizawa T, Osuka K, Nakajima T, Yoshida J. Bilateral open-door cervical expansive laminoplasty with hydroxyapatite spacers and titanium screws. J Neurosurg 2002; 96 (1, Suppl): 22-28
  • 34 Sheen JJ, Jeon SR. Midline splitting cervical laminoplasty using allogeneic bone spacers: comparison of fusion rates between cervical spondylotic myelopathy and ossification of posterior longitudinal ligament. Korean J Neurotrauma 2014; 10 (02) 60-65
  • 35 Kono H, Matsuda H, Maeno T, Iwamae M, Nakamura H. Open-door laminoplasty with stand-alone autologous bone spacers: evaluation of enlarged laminar arch with CT-multiplanar reconstruction. J Neurosurg Spine 2021; 35 (05) 1-5
  • 36 Tanaka N, Nakanishi K, Fujimoto Y. et al. Expansive laminoplasty for cervical myelopathy with interconnected porous calcium hydroxyapatite ceramic spacers: comparison with autogenous bone spacers. J Spinal Disord Tech 2008; 21 (08) 547-552
  • 37 Sasai K, Umeda M, Wakabayashi H, Maruyama T, Iida N, Akagi S. Comparison of bone bonding between spinous process-splitting laminoplasty and en-bloc laminoplasty using hydroxyapatite spacers in cervical spine: minimum 2 years follow-up. J Japan Spine Res Society 2007; 18: 371
  • 38 Kaito T, Hosono N, Makino T, Kaneko N, Namekata M, Fuji T. Postoperative displacement of hydroxyapatite spacers implanted during double-door laminoplasty. J Neurosurg Spine 2009; 10 (06) 551-556
  • 39 Kanemura A, Doita M, Iguchi T, Kasahara K, Kurosaka M, Sumi M. Delayed dural laceration by hydroxyapatite spacer causing tetraparesis following double-door laminoplasty. J Neurosurg Spine 2008; 8 (02) 121-128
  • 40 Dickerman RD, Reynolds AS, Tackett J, Morgan B. Dural laceration. J Neurosurg Spine 2008; 9 (01) 104 , author reply 104–105
  • 41 Takeoka Y, Yurube T, Maeno K. et al. Improved bone bonding of hydroxyapatite spacers with a high porosity in a quantitative computed tomography-image pixel analysis: a prospective 1-year comparative study of the consecutive cohort undergoing double-door cervical laminoplasty. JOR Spine 2020; 3 (01) e1080
  • 42 Iguchi T, Kanemura A, Kurihara A. et al. Cervical laminoplasty: evaluation of bone bonding of a high porosity hydroxyapatite spacer. J Neurosurg 2003; 98 (2, Suppl): 137-142
  • 43 O'Brien MF, Peterson D, Casey AT, Crockard HA. A novel technique for laminoplasty augmentation of spinal canal area using titanium miniplate stabilization. A computerized morphometric analysis. Spine 1996; 21 (04) 474-483 , discussion 484
  • 44 Liu FY, Ma L, Huo LS. et al. Mini-plate fixation versus suture suspensory fixation in cervical laminoplasty: a meta-analysis. Medicine (Baltimore) 2017; 96 (05) e6026
  • 45 Kobayashi Y, Matsumaru S, Kuramoto T. et al. plate fixation of expansive open-door laminoplasty decreases the incidence of postoperative C5 palsy. Clin Spine Surg 2019; 32 (04) E177-E182
  • 46 Lin X, Chen K, Tang H, Huang X, Wei C, Xiao Z. Comparison of anchor screw fixation versus mini-plate fixation in unilateral expansive open-door laminoplasty for the treatment of multi-level cervical spondylotic myelopathy. Medicine (Baltimore) 2018; 97 (49) e13534
  • 47 Shrestha D, Jun M, Jidong Z, Qiang BJ. Effect of titanium miniplate fixation on hinge fracture and hinge fracture displacement following cervical open-door laminoplasty. Int J Spine Surg 2020; 14 (04) 462-475
  • 48 Chung JY, Lee JJ, Kim JS, Seo HY. New cervical laminoplasty polyethererketone cage: two case reports. Asian Spine J 2007; 1 (01) 53-56
  • 49 Rhee JM, Register B, Hamasaki T, Franklin B. Plate-only open door laminoplasty maintains stable spinal canal expansion with high rates of hinge union and no plate failures. Spine 2011; 36 (01) 9-14
  • 50 Hirabayashi K, Satomi K. Operative procedure and results of expansive open-door laminoplasty. Spine 1988; 13 (07) 870-876
  • 51 Satomi K, Nishu Y, Kohno T, Hirabayashi K. Long-term follow-up studies of open-door expansive laminoplasty for cervical stenotic myelopathy. Spine 1994; 19 (05) 507-510
  • 52 Lee DH, Kim H, Lee CS, Hwang CJ, Cho JH, Cho SK. Clinical and radiographic outcomes following hinge fracture during open-door cervical laminoplasty. J Clin Neurosci 2017; 43: 72-76
  • 53 Cho SH, Lee JH, Chough CK. et al. Hinge fracture during cervical open-door laminoplasty: does it affect clinical and radiographic outcomes?. Korean J Spine 2014; 11 (02) 45-51
  • 54 Hur JW, Park YK, Kim BJ, Moon HJ, Kim JH. Risk factors for delayed hinge fracture after plate-augmented cervical open-door laminoplasty. J Korean Neurosurg Soc 2016; 59 (04) 368-373
  • 55 Rosinski A, Odeh K, Leasure J, Kondrashov D. Motion preservation at all costs? Multilevel hinge nonunion, plate breakage, and intradural plate migration after cervical laminoplasty: a case report and literature review. World Neurosurg 2020; 135: 80-86
  • 56 Nasto LA, Muquit S, Perez-Romera AB, Mehdian H. Clinical outcome and safety study of a newly developed instrumented French-door cervical laminoplasty technique. J Orthop Traumatol 2017; 18 (02) 135-143
  • 57 Katonis P, Papadakis SA, Galanakos S. et al. Lateral mass screw complications: analysis of 1662 screws. J Spinal Disord Tech 2011; 24 (07) 415-420
  • 58 Liu G, Buchowski JM, Riew KD. Screw back-out following “open-door” cervical laminoplasty: a review of 165 plates. Asian Spine J 2015; 9 (06) 849-854
  • 59 Chen H, Li H, Wang B. et al. Facet joint disturbance induced by miniscrews in plated cervical laminoplasty: dose it influence the clinical and radiologic outcomes?. Medicine (Baltimore) 2016; 95 (38) e4666
  • 60 Chen H, Li H, Deng Y. et al. Optimal area of lateral mass mini-screws implanted in plated cervical laminoplasty: a radiography anatomy study. Eur Spine J 2017; 26 (04) 1140-1148
  • 61 Chen H, Liu H, Li T. et al. Effect of penetration of mini-plate lateral mass screws into facet joint on axial symptoms in cervical laminoplasty. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2013; 27 (11) 1324-1330