Effect of Laminoplasty with Reconstructing of Cervical Extensor Attachment on Cervical Spondylotic Myelopathy Involving C2 Segment
10.3969/j.issn.1006-9771.2019.02.018
- VernacularTitle:颈后伸肌附着点重建椎管成形术对累及C2节段脊髓型颈椎病的疗效
- Author:
Jin-hui TIAN
1
;
Zhi-yuan LI
1
;
Fa-jing LIU
1
;
Bing-zhi LIU
1
;
Xiao-dong LI
1
;
Jie MIAO
1
Author Information
1. The Fifth Department of Orthopedics, Handan Central Hospital, Handan, Hebei 056001, China
- Publication Type:Research Article
- Keywords:
cervical spondylotic myelopathy;
single open-door laminoplasty;
reconstruction of extensor muscle attachment;
titanium plate;
axial symptoms
- From:
Chinese Journal of Rehabilitation Theory and Practice
2019;25(2):224-229
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the efficacy of laminoplasty with reconstructing of cervical extensor attachment on cervical spondylotic myelopathy (CSM) involving C2 segment. Methods:From March, 2014 to January, 2017, 46 cases with CSM involving C2 accepted surgery in our hospital. They were divided into two groups according to the surgical methods. Control group (n = 21) accepted traditional laminoplasty, while observation group (n = 25) accepted laminoplasty with extensor muscle attachment point reconstruction. They were assessed with Japanese Orthopaedic Association (JOA) spinal scores, cervical range of motion (ROM), cervical curvature, areas of posterior cervical muscles and axial symptoms. Results:There was no significant difference at operative time and intraoperative blood loss (t < 0.863, P > 0.05) between groups. After surgery, the JOA score increased in both groups (F > 24.961, P < 0.001), but there was no significant difference between two groups (t < 0.282, P > 0.05). ROM varied little in both groups (F < 0.931, P > 0.05). The cervical neutral position curvature decreased in the control group (F = 8.241, P < 0.01), but not in the observation group (F = 2.705, P > 0.05). The areas of posterior muscle decreased in control group (t = 2.678, P < 0.05), but not in the observation group (t = 0.854, P > 0.05). The incidence of axial symptoms was less in the observation group than in the control group (Z = -2.192, P < 0.05). Conclusion:Laminoplasty could relieve the spinal compression at C2 segment and promote the recovery of neurological function, and it can do better in cervical curvature and posterior cervical muscle atrophy as combination with reconstruction of extensor muscle attachment, to reduce the axial symptoms.
