Probe Laminotomy: A Simple Technique for Precise Lateral Gutter Placement in Cervical Expansive Laminoplasty

Abstract

In cervical expansive laminoplasty, precise placement of lateral gutters is important. Placing them too medially results in suboptimal canal expansion, and placing them too laterally results in facet joint violation. However, precise placement is often difficult. We have included a simple procedure called probe laminotomy in cervical expansive laminoplasty since 2013. This technique consisted of identifying the location of the pedicles through a small laminotomy with medial facetectomy before making lateral gutters. A case-control study was performed to compare the achieved postoperative canal area and duration of surgery between the original technique and the added probe laminotomy. The postoperative canal area was 21% larger in the probe laminotomy group compared with the standard technique group (P= 0.0003). There was no significant difference in duration of surgery between the groups. This technique facilitated more precise placement of the lateral gutter in cervical expansive laminoplasty, which resulted in a larger postoperative canal. This technique should be considered as an option in cervical expansive laminoplasty.