|
|
|
| Curative effect of cervical posterior single open-door laminoplasty plus single lateral mass screw-rod for myelopathic cervical spondylosis with cervical kyphosis |
| SHAO Bin, WANG Dawei, XING Jianqiang, SUN Jinchuan, ZHANG Zheng, ZHAO Wei, YE Weikang, FANG Qingmin |
| Department of Spinal Surgery, Binzhou Medical University Hospital, Binzhou 256603, P.R.China |
|
|
|
|
Abstract Objective To investigate the curative effect of cervical posterior single open-door laminoplasty plus single lateral mass screw-rod internal fixation for myelopathic cervical spondylosis with cervical kyphosis.Methods From Jan.2013 to June 2016,23 patients with cervical spondylotic myelopathy treated with cervical posterior single open-door laminoplasty plus lateral mass screw-rod were selected,including 11 males and 12 females, with the ages from 55 to 72 years old and with a mean age of 65 years old. All of them received cervical posterior single open-door laminoplasty plus lateral mass screw-rod.Three days and one year after the operation,the cervical vertebra X ray and MRI were reviewed and the changes of cervical curvature were observed.One year after the operation,JOA scoring statistics were performed on the neurological function of patients,and the improvement rate of neurological function was calculated.Results All the 23 patients received cervical posterior single open-door laminoplasty plus lateral mass screw-rod Under the general anesthesia.The mean operative time was 65min ranging from 50 to 80min. The mean volume of blood loss was 120ml ranging from 50ml to 200ml. Preoperative JOA score was from 5 to 10,with the average 7.5±2.0, while one year after the operation the score of JOA was from 10 to 16,with the average of 13.3±2.1, which was significantly higher than the preoperative score.Preoperative cervical Cobb angle was from -21to -29° with the average 26.1±2.3°.Three days after the surgery,X showed a Cobb Angle of -6.5±2.9°,which was better than that before the surgery, and the patient was significantly relieved.One year after the surgery,the Cobb Angle was shown to be -7.2±2.6°, which was better than that before the surgery.Conclusion These results indicate that the cervical posterior single open-door laminoplasty plus single lateral mass screw-rod can improve cervical curvature and has reliable curative effect.
|
|
Received: 11 August 2018
|
|
|
|
|
|
[1] Nottmeier E W,Deen H G,Patel N,et al.Cervical kyphotic deformity correction using 360-degree reconstruction[J]. Clinical Spine Surgery,2009,22(6):385-391.
[2] Sin A H,Acharya R,Smith D R,et al.Adopting 540-degree fusion to correct cervical kyphosis[J].Surgical neurology,2004,61(6):515-522.
[3] Grosso M J,Hwang R, Krishnaney A A,et al.Complications and outcomes for surgical approaches to cervical kyphosis[J].Clinical Spine Surgery,2015,28(7):E385-E393.
[4] Jain A,Rustagi T,Prasad G,et al.Does Segmental Kyphosis Affect Surgical Outcome after a Posterior Decompressive Laminectomy in Multisegmental Cervical Spondylotic Myelopathy?[J].Asian Spine Journal,2017,11(1):24-30.
[5] Cho W S,Chung C K,Jahng T A,et al.Post-laminectomy kyphosis in patients with cervical ossification of the posterior longitudinal ligament:does it cause neurological deterioration?[J].J Korean Neurosurg Soc,2008,43(6):259-264.
[6] 关晓明,马迅,冯皓宇,等.多节段脊髓型颈椎病伴后凸畸形不同入路方式的选择及疗效[J].中国脊柱脊髓杂志,2016,26(6):481-487.
[7] Miyamoto H,Maeno K,Uno K,et al.Outcomes of surgical intervention for cervical spondylotic myelopathy accompanying local kyphosis (comparison between laminoplasty alone and posterior reconstruction surgery using the screw-rod system)[J].European Spine Journal,2014, 23(2):341-346.
[8] Matz P G,Anderson P A,Groff M W,et al.Cervical laminoplasty for the treatment of cervical degenerative myelopathy[J].Journal of Neurosurgery:Spine,2009,11(2):157-169.
[9] Ohnari H,Sasai K,Akagi S,et al.Investigation of axial symptoms after cervical laminoplasty,using questionnaire survey[J].The Spine Journal,2006,6(3):221-227.
[10] 孙程帅,李雷,孟伟宁.颈椎后路椎弓根螺钉内固定术治疗脊髓型颈椎病患者的疗效分析[J].沈阳医学院学报,2016,18(4):245-247,250.
[11] Martus J E,Griffith T E,Dear J C,et al.Pediatric cervical kyphosis:a comparison of arthrodesis techniques[J].spine,2011,36(17):E1145-E1153.
[12] 杜伟,申勇,张英泽,等.后路选择性扩大减压侧块螺钉内固定治疗伴有曲度后凸的多节段颈椎病[D].石家庄:河北医科大学,2013.
[13] Tashjian V S,Kohan E,McArthur D L,et al.The relationship between preoperative cervical alignment and postoperative spinal cord drift after decompressive laminectomy and arthrodesis for cervical spondylotic myelopathy[J].Surgical neurology,2009,72(2):112-117.
[14] Hatta Y,Shiraishi T,Hase H,et al.Is posterior spinal cord shifting by extensive posterior decompression clinically significant for multisegmental cervical spondylotic myelopathy?[J].Spine,2005,30(21):2414-2419. |
|
|
|
