1.Application of titanium miniplate to posterior cervical laminoplasty:a short-term follow-up
Baizhen XIE ; Qiang HUA ; Huiyi ZHAO
Chinese Journal of Tissue Engineering Research 2014;(35):5681-5686
BACKGROUND:During cervical posterior expansive open-door laminoplasty for multisegmental cervical spondylosis, spinal canal restenosis, loss of cervical lordosis, and axial symptoms are the important factors affecting curative effects. It is very necessary to maintain spinal canal expanded state and to reduce interference of the posterior cervical structure in the clinical treatment. OBJECTIVE:To observe clinical outcomes and short-term fol ow-up effect of posterior expansive open-door laminoplasty via titanium miniplate in treatment of cervical spondylotic myelopathy. METHODS:A total of 67 patients with cervical spondylotic myelopathy who underwent posterior expansive open-door laminoplasty at the Zhongshan Hospital, Xiamen University from April 2006 to April 2013 were retrospectively analyzed. Titanium miniplate group (n=27) received titanium miniplate fixation. Suture group (n=40) received traditional suture suspension. Al patients had decompression ranged from C 3-7 . Operation time, intraoperative blood loss, improvement rate of Japanese Orthopedic Association score during fol ow-up, value of cervical curvature, axial symptoms, and lamina opened angle were compared between the two groups. RESULTS AND CONCLUSION:No significant difference in operation time, intraoperative blood loss and improvement rate of Japanese Orthopedic Association score was detectable between two groups (P>0.05). Cervical curvature changes in both groups:loss of cervical curvature at 6 months postoperation was not significant in the titanium miniplate group, but cervical curvature partial y lost in the suture group, and significant differences in the cervical curvature were detected between the two groups (P<0.05). The incidence of axial symptoms was significantly lower in the titanium miniplate group than in the suture group at 6 months after surgery (P<0.05). During final fol ow-up, no significant difference in the lamina open-angle was detected between titanium miniplate group (35.2±6.2)° and suture group (34.0±4.7)° (P>0.05). These data suggested that posterior expansive open-door laminoplasty for treatment of cervical spondylotic myelopathy using both titanium miniplate and suture methods can obtain good clinical outcomes. However, titanium miniplate fixation can relieve postoperative axial symptoms and prevent loss of cervical curvature.