Two kinds of decompression and implant internal fixation for the treatment of cervical spinal stenosis:C5 nerve root palsy and stability
10.3969/j.issn.2095-4344.2013.35.020
- VernacularTitle:两种减压植入内固定方式治疗颈椎管狭窄症：C5神经根麻痹及稳定性
- Author:
Weizhi LIANG
;
Jinwei GAO
;
Lei FU
;
Xiaohu CUI
;
Junfeng JIA
- Publication Type:Journal Article
- Keywords:
bone and joint implants;
academic discussion of bone and joint;
cervical spinal stenosis;
lateral mass screw internal fixation;
laminectomy;
single-door decompression;
laminoplasty;
nerve root palsy
- From:
Chinese Journal of Tissue Engineering Research
2013;(35):6345-6350
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Some scholars suggest that the nerve root palsy after cervical spinal stenosis treated with
decompression and implant internal fixation is related with the cervical stability and cervical lordosis, but there is controversial.
OBJECTIVE:To explore the C 5 nerve root palsy and stability after cervical spinal stenosis treated with posterior laminectomy lateral mass fixation and single-door decompression laminoplasty.
METHODS:Twenty-nine cervical spinal stenosis patients were selected and treated with posterior
decompression and implant internal fixation. Posterior laminectomy lateral mass fixation for the treatment of
cervical spinal stenosis:C3-6 lateral mass and C7 pedicel screw internal fixation was performed and caused rough surface on the facet joint;the unstable segment was confirmed according to the preoperative anteraposterior
plain film and dynamic radiographs combined with MRI and CT images, and then the corresponding segments were treated with lateral mass internal fixation, single-door decompression laminoplasty and laminoplasty.
RESULTS AND CONCLUSION:Al the 29 cervical spinal stenosis patients were fol owed-up for 8 months to 2.3 years. Among them, 14 cases were treated with posterior laminectomy lateral mass fixation, two cases had nerve root palsy in the early stage after implantation, three cases had incomplete paralysis after long-term symptom recurrence and treated with second surgery of scar remove and decompression;15 cases were treated with single-door decompression
laminoplasty, and one case had C 5 never root palsy and shoulder abduction dysfunctionafter treatment, no preoperative symptom recurrence. The nerve root palsy wil restored in 6 weeks for shortest and 9 months for longest. As the limitation of the case number, it is not clear whether there were significant differences in the correlation between C 5 nerve root
palsy and segmental stability, cervical lordosis, spinal decompression degree and the range for spinal cord shift, as wel as the nerve root palsy degree and the cervical spinal stenosis recurrence caused by forward scar between two
treatment methods, so accumulation observation of the cases and clinical experience are needed.
