Laminopediculoplasty: a new method of reconstructing the posterior elements of the thoracic spine.

We describe a new method of reconstructing the posterior elements of the thoracic spine following decompression of the cord through a wide posterior approach. Osteoperiosteal corticocancellous grafts are harvested from the iliac wing, then bent into a semicircle with the periosteum on the inside and inserted between the resected vertebral pedicles where they act as a base for further grafting. The posterior spinoligamentous complex is preserved and reattached. This technique permits circumferential decompression of the thoracic cord through a posterior approach and posterior thoracic interbody fusion. Fifteen patients were treated by this method and a solid fusion achieved in each case. No bony ingrowth into the spinal canal was observed.