Open-door laminoplasty with lateral mass screw fusion in the treatment of multisegmental cervical spondylotic myelopathy with segmental instability
10.3760/cma.j.issn.0254-9026.2018.02.015
- VernacularTitle:后路单开门椎板成形侧块螺钉内固定术治疗合并不稳定的多节段脊髓型颈椎病患者疗效和安全性
- Author:
Xiaobin WANG
1
;
Zilong YIN
;
Qiang WANG
;
Kuiyuan LU
;
Changtai SUN
Author Information
1. 100730,北京医院国家老年医学中心骨科中国老年脊柱外科中心
- Keywords:
Cervical spondylotic myelopathy;
Segmental instability;
Laminoplasty;
Lateral mass screw
- From:
Chinese Journal of Geriatrics
2018;37(2):179-182
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effectiveness of open-door laminoplasty with lateral mass screw fusion in the treatment of multisegmental cervical spondylotic myelopathy (CSM)with segmental instability.Methods Forty-one patients with multisegmental cervical spondylotic myelopathy combined with instability underwent open-door laminoplasty with lateral mass screw fusion.The JOA(Japanese Orthopaedic Association)scoring system and Neck Disability Index(NDI) were applied to evaluate neurological function and axial neck/shoulder pain before and after surgery,respectively.In addition,the Ishihara method was used to measure the cervical curvature index(CCI),and spinal cord expansion was calculated with MRI.Results After 43 months of postoperative follow-up,there were significant differences in JOA scores[(7.12±0.91) vs.(14.73± 1.12),t =35.28,P＜0.001],areas of the dural sac at the level of maximum stenosis in MRI[(0.22±0.05)]cm2 vs.(0.62±0.09)cm2,t=14.15,P＜0.001],and NDI scores[(24.46±6.61) vs.(12.90±3.46),t=15.59,P ＜ 0.001],compared with those before treatment.However,there were no significant differences in pre-and post-operation CCI[(10.36±1.69) vs.(10.87±2.05),t=1.11,P＞0.05].Conclusions Open-door laminoplasty with lateral mass screw fusion can improve neurological function and maintain the normal cervical curvature.Therefore,it is effective in the treatment of multisegmental cervical spondylotic myelopathy with segmental instability.
