Bone Plate System for Open Door Laminoplasty Stabilization
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Solution Overview
Problem
The traditional open door laminoplasty procedure is risky due to the need to drill and screw over an open spinal cord and unstable hinged lamina, which can lead to instability and potential breakage during the surgical procedure.
Innovation Solution
A bone plate system is introduced where the laminar screw is placed before making cuts in the laminae, allowing for secure fixation and stabilization of the lamina without the need for drilling over an open spinal cord, using a U-shaped plate design that spans the gap between bony segments and is secured with fixation elements to maintain the lamina in an open position.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If the traditional open door laminoplasty procedure is used where cuts are made in the lamina before screw placement, then the surgical procedure can be completed with standard techniques, but the risk of instability and potential breakage increases due to drilling over an open spinal cord and unstable hinged lamina
Solution Approach 1:
The laminar screw is placed in the lamina before the hinge cut is made, which is the reverse of the traditional sequence. This preliminary placement of the screw provides stabilization before the lamina is cut, eliminating the risk of drilling over an unstable hinged structure and open spinal cord. The screw acts as a preliminary anchor that prevents breakage during subsequent cutting and manipulation steps.
2Reliability
If the lamina is cut to create the open door hinge, then the spinal cord decompression is achieved, but the hinged side becomes prone to breakage if excess pressure is applied
Solution Approach 1:
The laminar screw is inserted into the lamina before the hinge cut is performed. This preliminary action creates a stable anchor point that reinforces the lamina structure before it is weakened by cutting. The screw prevents the hinged portion from breaking under excess pressure during the surgical procedure, maintaining both decompression and structural integrity.
3Ease of operation
If drilling is performed over an open spinal cord to place laminar screws, then the lamina can be fixed in position, but the risk of damaging the spinal cord or creating instability increases
Solution Approach 1:
The traditional sequence is inverted: instead of cutting the lamina first and then drilling screws over the open spinal cord, the screw is placed first in the intact lamina, and then the hinge cut is made. This inversion eliminates the need to drill over an exposed spinal cord, removing the harmful factor while maintaining the ability to fix the lamina in position.
Data Source
AI summary
A bone plate system for use in an “open door” laminoplasty procedure, including a bone plate, a first fixation element, and at least one second fixation element. The bone plate is elongated and has a generally curved shape such that the plate has an associated radius of curvature. The plate is sized and dimensioned to span a gap between a pair of bony segments, for example a pair of bony segments constituting a divided lamina. The first and second fixation elements are each configured to securely attach the bone plate to the bony segments. The bone plate has a first end including a generally U-shaped slot extending therein such that the open end of the slot comprises a first terminal end of the plate.