A control study on titanium miniplate and anchor fixation to prevent laminar closure in open-door laminoplasty
10.3760/cma.j.issn.0253-2352.2013.10.001
- VernacularTitle:比较单开门颈椎椎板成形术中锚定法与钛板固定对预防椎板关闭的效果
- Author:
Jun WAN
;
Haisen ZHANG
;
Yu ZHANG
;
Qiang HE
;
Bin YU
;
Yingpeng XIA
;
Xueli ZHANG
- Publication Type:Journal Article
- Keywords:
Cervical spondylosis;
Surgical procedures,operative;
Comparative study
- From:
Chinese Journal of Orthopaedics
2013;33(10):977-983
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the prophylactic effect of laminar closure between titanium miniplate and anchor fixation in open-door cervical laminoplasty.Methods Between January 2010 and December 2010,63 patients with cervical spondylotic myelopathy were treated by open-door laminoplasty.Of them,30 patients underwent laminoplasty by titanium miniplate fixation and 33 by anchor fixation.During follow-up,multi-detector CT was performed preoperatively,at 1 week and 6 months after surgery.At each level,the anteroposterior diameter (APD) of the spinal canal and opening angle (OA) were measured.And the spinal canal expansion rate are calculated.MRI was performed preoperatively and 1 year after surgery to evaluate the severity of cord compression.Results All incisions healed by first intention.The incidence of postoperative axial symptoms in miniplate fixation group and anchor fixation group were 33.3％ (10/30) and 39.4％ (13/33),respectively.The OA,APD,and the spinal canal expansion rate of patients in both groups improved significant postoperatively,but differing from miniplate fixation group.The OA,the APD and the spinal canal expansion rate in anchor fixation group after 6 months were reduced than one week after surgery,and the difference between the groups was statistically significant.Lamina close in two groups was not found.CT images at 6 months showed complete fusion of the hinge area by mature bone or callus in two groups,by cervical sagittal MRI assessment.The severity of spinal cord compression was improved after 1 year.Preoperative and 1 year after the surgery,the severity of spinal cord compression between the two groups showed no significant difference.The severity of spinal cord compression after 1 year in both groups were no more than three grade.Conclusion Open-door cervical laminoplasty by anchor fixation or titanium miniplate can effectively prevent the occurrence of postoperative lamina closure,which can help patients to do functional exercises early,but improvement of spinal cord compression has no significant difference between both of them.However,titanium miniplate fixation for maintenance of the expansive spinal canal is better.
