Comparative results between posterior laminoplasty with foraminotomy and anterior cervical discectomy and fusion for cervical radiculomyelopathy
10.3760/cma.j.issn.0253-2352.2014.08.002
- VernacularTitle:后路单开门联合椎间孔切开术与前路减压融合术治疗混合型颈椎病的疗效比较
- Author:
Zhao FANG
;
Rong TIAN
;
Tianwei SUN
;
Yutao JIA
;
Tiantong XU
;
Gang XIA
- Publication Type:Journal Article
- Keywords:
Cervical vertebrae;
Spinal cord compression;
Radiculopathy;
Foraminotomy
- From:
Chinese Journal of Orthopaedics
2014;(8):799-806
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the clinical and radiologic outcomes between laminoplasty with forominotomy(LF) and anterior cervical discectomy and fusion(ACDF) in treating cervical radiculomyelopathy(CRM). Methods Datas of 68 patients (ACDF=33, LF=35) from January 2008 to January 2010 was collected retrospectively, the follow-up is at least 2 years. The Japa-nese Orthopedic Association (JOA) score and associated recovery rate were evaluated. For radiographic evaluation, the lordotic an-gle and range of motion (ROM) at C2-C7 were investigated. The Neck Disabilitv Index Scale(NDI) was used to evaluate the degree of patient’pain at the last follow-up. Results Patients’demographics were similar between the two groups. The differences be-tween ACDF and LF in operative time (187min VS 154min),the blood loss (127 ml VS 235 ml) and the sensation of lower extremity (64.0%VS 66.0%) are significant(t=4.170, P=0.000;Z=-6.888, P=0.000;Z=-7.512, P=0.000). 1 case with failed fusion of bone graft 3 months post-operation. 3 cases of adjacent segment degenerative changes occurred at the 2nd year follow-up in ACDF group. But no such complications occurred in the EOLF group. In addition, ACDF group showed lower NDI score than LF group in extracting and amusing (Z=-3.947, P=0.000;t=-7. 523, P=0.000). Cervical lordosis of ACDF increased from 13.7° to 16.2°, while that of LF group decreased from 14.6° to 13.3°(Z=-3.374,P=0.001);Both of the two groups (ACDF/LF) exhibited decreased cervi-cal ROM (14.8° VS 16.5°, t=-2.167, P=0.034). Conclusion The two surgical procedures have similar clinical effects in treating multi-segmental CRM. However, the LF group demonstrated shorter operative time, fewer short-term complications, so it proved to be effective and safe surgical procedure.
