A Novel Method of Making Hinges Using a Newly Designed Sharp Rongeur to Enhance Radiological and Clinical Outcomes in French‐Door Cervical Expansive Laminoplasty
Objective Although the lamina open angle of making hinges is closely related to the outcomes of French‐door laminoplasty (FDL) for treatment of cervical spondylosis, there have been no methods to predict the lamina open angle preoperatively as yet. The aim of this study was to investigate the accura...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.13505 |
| _version_ | 1811205222036406272 |
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| author | Ningning Chen Lanzhe Yu Xizhe Liu Guoliang Chen Yanrun Li Xuenong Zou Dacheng He Jiaming Yang Shangbin Cui Le Wang Shaoyu Liu Fuxin Wei |
| author_facet | Ningning Chen Lanzhe Yu Xizhe Liu Guoliang Chen Yanrun Li Xuenong Zou Dacheng He Jiaming Yang Shangbin Cui Le Wang Shaoyu Liu Fuxin Wei |
| author_sort | Ningning Chen |
| collection | DOAJ |
| description | Objective Although the lamina open angle of making hinges is closely related to the outcomes of French‐door laminoplasty (FDL) for treatment of cervical spondylosis, there have been no methods to predict the lamina open angle preoperatively as yet. The aim of this study was to investigate the accuracy of predicting the laminal open angle using our newly designed sharp rongeur, and to compare the postoperative outcomes and complications between the methods of making hinges using the newly designed sharp rongeur and the traditional high‐speed micro‐drill during the FDL. Methods This was a single‐center retrospective study. Following the approval of the institutional ethics committee, a total of 39 patients (Male: 28; Female: 11) diagnosed with cervical spondylos who underwent FDL in our institution between January 2018 and May 2019 were enrolled. Patients were divided into two groups based on the method of making hinges (sharp rongeur: 22 cases; high‐speed micro‐drill: 17 cases). The average age at surgery was 59.1 years (range: 16–85 years). The radiological parameters, clinical outcomes, modified Japanese Orthopaedic Association (mJOA) scale score, and the recovery rate of mJOA were recorded and compared between the groups, respectively. The radiological parameters and clinical measurements at pre‐ and post‐operation stages were compared using the paired‐sample t‐test, the Wilcoxon signed‐rank test, and the Friedman's test, and variables in the two groups were analyzed using an unpaired Student's t‐test or a Mann–Whitney U test. Results The average follow‐up period was 20.4 months (range: 14.0–25.9 months), the postoperative open angle was 60.13° ± 3.69° in the rongeur group with 22.78° ± 4.34° of angular enlargement, which was significantly lower than that of 68.96° ± 1.00° in the micro‐drill group with 32.75° ± 4.22° of angular enlargement (U = 19.000, p < 0.001). The rongeur group showed a higher fusion rate (34.1% vs 14.7%, χ2 = 11.340, p = 0.001), and a lower fracture rate of the lamina (7.8% vs 25.5%, χ2 = 14.185, p < 0.001) at 1‐month post‐surgery, compared to the micro‐drill group. There were no significant differences in the clinical outcomes and postoperative complications between the two groups (p > 0.05), except in the recovery rate of mJOA scores (0.836 ± 0.138 vs 0.724 ± 0.180, U = 115.000, p = 0.042) and neck disability index (NDI) at the final follow‐up (7.55 ± 10.65 vs 14.71 ± 8.72, U = 94.000, p = 0.008). Conclusions The special sharp rongeur with a tip angle of 20° could be a preferred method to make hinges during FDL, which can predict the laminal open angle accurately and enlarge it to about 23°, thus reducing the fracture rate and accelerating the bony fusion of hinges compared with the outcomes of the traditional micro‐drill method. |
| first_indexed | 2024-04-12T03:28:16Z |
| format | Article |
| id | doaj.art-5e981b09dfdf4fb192a5aebf4ec4f0c0 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-12T03:28:16Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
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| series | Orthopaedic Surgery |
| spelling | doaj.art-5e981b09dfdf4fb192a5aebf4ec4f0c02022-12-22T03:49:37ZengWileyOrthopaedic Surgery1757-78531757-78612022-12-0114123349335710.1111/os.13505A Novel Method of Making Hinges Using a Newly Designed Sharp Rongeur to Enhance Radiological and Clinical Outcomes in French‐Door Cervical Expansive LaminoplastyNingning Chen0Lanzhe Yu1Xizhe Liu2Guoliang Chen3Yanrun Li4Xuenong Zou5Dacheng He6Jiaming Yang7Shangbin Cui8Le Wang9Shaoyu Liu10Fuxin Wei11Department of Orthopaedic Surgery The Seventh Affiliated Hospital of Sun Yat‐sen University Shenzhen ChinaDepartment of Orthopaedic Surgery Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University) Zhuhai ChinaDepartment of Spine Surgery The First Affiliated Hospital and Orthopedic Research Institute of Sun Yat‐sen University Guangzhou ChinaDepartment of Orthopaedic Surgery The Seventh Affiliated Hospital of Sun Yat‐sen University Shenzhen ChinaDepartment of Orthopaedic Surgery The Seventh Affiliated Hospital of Sun Yat‐sen University Shenzhen ChinaDepartment of Spine Surgery The First Affiliated Hospital and Orthopedic Research Institute of Sun Yat‐sen University Guangzhou ChinaDepartment of Orthopaedic Surgery The Seventh Affiliated Hospital of Sun Yat‐sen University Shenzhen ChinaDepartment of Orthopaedic Surgery The Seventh Affiliated Hospital of Sun Yat‐sen University Shenzhen ChinaDepartment of Spine Surgery The First Affiliated Hospital and Orthopedic Research Institute of Sun Yat‐sen University Guangzhou ChinaDepartment of Spine Surgery The First Affiliated Hospital and Orthopedic Research Institute of Sun Yat‐sen University Guangzhou ChinaDepartment of Orthopaedic Surgery The Seventh Affiliated Hospital of Sun Yat‐sen University Shenzhen ChinaDepartment of Orthopaedic Surgery The Seventh Affiliated Hospital of Sun Yat‐sen University Shenzhen ChinaObjective Although the lamina open angle of making hinges is closely related to the outcomes of French‐door laminoplasty (FDL) for treatment of cervical spondylosis, there have been no methods to predict the lamina open angle preoperatively as yet. The aim of this study was to investigate the accuracy of predicting the laminal open angle using our newly designed sharp rongeur, and to compare the postoperative outcomes and complications between the methods of making hinges using the newly designed sharp rongeur and the traditional high‐speed micro‐drill during the FDL. Methods This was a single‐center retrospective study. Following the approval of the institutional ethics committee, a total of 39 patients (Male: 28; Female: 11) diagnosed with cervical spondylos who underwent FDL in our institution between January 2018 and May 2019 were enrolled. Patients were divided into two groups based on the method of making hinges (sharp rongeur: 22 cases; high‐speed micro‐drill: 17 cases). The average age at surgery was 59.1 years (range: 16–85 years). The radiological parameters, clinical outcomes, modified Japanese Orthopaedic Association (mJOA) scale score, and the recovery rate of mJOA were recorded and compared between the groups, respectively. The radiological parameters and clinical measurements at pre‐ and post‐operation stages were compared using the paired‐sample t‐test, the Wilcoxon signed‐rank test, and the Friedman's test, and variables in the two groups were analyzed using an unpaired Student's t‐test or a Mann–Whitney U test. Results The average follow‐up period was 20.4 months (range: 14.0–25.9 months), the postoperative open angle was 60.13° ± 3.69° in the rongeur group with 22.78° ± 4.34° of angular enlargement, which was significantly lower than that of 68.96° ± 1.00° in the micro‐drill group with 32.75° ± 4.22° of angular enlargement (U = 19.000, p < 0.001). The rongeur group showed a higher fusion rate (34.1% vs 14.7%, χ2 = 11.340, p = 0.001), and a lower fracture rate of the lamina (7.8% vs 25.5%, χ2 = 14.185, p < 0.001) at 1‐month post‐surgery, compared to the micro‐drill group. There were no significant differences in the clinical outcomes and postoperative complications between the two groups (p > 0.05), except in the recovery rate of mJOA scores (0.836 ± 0.138 vs 0.724 ± 0.180, U = 115.000, p = 0.042) and neck disability index (NDI) at the final follow‐up (7.55 ± 10.65 vs 14.71 ± 8.72, U = 94.000, p = 0.008). Conclusions The special sharp rongeur with a tip angle of 20° could be a preferred method to make hinges during FDL, which can predict the laminal open angle accurately and enlarge it to about 23°, thus reducing the fracture rate and accelerating the bony fusion of hinges compared with the outcomes of the traditional micro‐drill method.https://doi.org/10.1111/os.13505Cervical expansive laminoplastyFrench‐door laminoplastyLamina open angle predictionOutcomesSharp rongeur |
| spellingShingle | Ningning Chen Lanzhe Yu Xizhe Liu Guoliang Chen Yanrun Li Xuenong Zou Dacheng He Jiaming Yang Shangbin Cui Le Wang Shaoyu Liu Fuxin Wei A Novel Method of Making Hinges Using a Newly Designed Sharp Rongeur to Enhance Radiological and Clinical Outcomes in French‐Door Cervical Expansive Laminoplasty Orthopaedic Surgery Cervical expansive laminoplasty French‐door laminoplasty Lamina open angle prediction Outcomes Sharp rongeur |
| title | A Novel Method of Making Hinges Using a Newly Designed Sharp Rongeur to Enhance Radiological and Clinical Outcomes in French‐Door Cervical Expansive Laminoplasty |
| title_full | A Novel Method of Making Hinges Using a Newly Designed Sharp Rongeur to Enhance Radiological and Clinical Outcomes in French‐Door Cervical Expansive Laminoplasty |
| title_fullStr | A Novel Method of Making Hinges Using a Newly Designed Sharp Rongeur to Enhance Radiological and Clinical Outcomes in French‐Door Cervical Expansive Laminoplasty |
| title_full_unstemmed | A Novel Method of Making Hinges Using a Newly Designed Sharp Rongeur to Enhance Radiological and Clinical Outcomes in French‐Door Cervical Expansive Laminoplasty |
| title_short | A Novel Method of Making Hinges Using a Newly Designed Sharp Rongeur to Enhance Radiological and Clinical Outcomes in French‐Door Cervical Expansive Laminoplasty |
| title_sort | novel method of making hinges using a newly designed sharp rongeur to enhance radiological and clinical outcomes in french door cervical expansive laminoplasty |
| topic | Cervical expansive laminoplasty French‐door laminoplasty Lamina open angle prediction Outcomes Sharp rongeur |
| url | https://doi.org/10.1111/os.13505 |
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