Effects of guttering on the lateral mass technique in the cross-sectional area of spinal canal after unilateral open-door cervical laminoplasty
10.3969/j.issn.1004-406X.2025.10.01
- VernacularTitle:侧块开槽技术对颈椎后路单开门椎管扩大椎板成形术后骨性椎管横截面积的影响
- Author:
Xiaolong SHEN
1
;
Huajian ZHONG
1
;
Leixin WEI
1
Author Information
1. 海军军医大学长征医院骨科 200003 上海市
- Publication Type:Journal Article
- Keywords:
Cervical vertebrae;
Cervical spondylosis;
Laminoplasty;
Lateral mass;
Guttering on the lateral mass
- From:
Chinese Journal of Spine and Spinal Cord
2025;35(10):1009-1018
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To explore the effects of guttering on the lateral mass technique in enlarging the cross-sectional area of the spinal canal after unilateral open-door cervical laminoplasty.Methods:A retro-spective analysis was conducted on the clinical data of patients with cervical ossification of posterior longitudi-nal ligament treated with unilateral open-door cervical laminoplasty between February 2021 and February 2024.37 patients who underwent the conventional technique were included in the conventional group;31 pa-tients undergone guttering on the lateral mass technique were included in the lateral mass group.The opera-tive time,intraoperative blood loss,postoperative drainage volume,and incidence of complications were compared between the two groups.At preoperation,immediately after surgery,2 months after surgery,and the final follow-up,the neck pain was evaluated using the visual analog scale(VAS),the cervical function was assessed with the neck disability index(NDI),and the neurological function was appraised with the Japanese Orthopaedic Association(JOA)score.C2-7 Cobb angle,C2-7 sagittal vertical axis(SVA),and T1 slope were measured on the cervical lateral X-rays to eliminate the possibilities of guttering on the lateral mass affecting cervical stability and cervical curvature;The spinal canal area was measured on the CT cross-sectional image and the percentage increase in spinal canal area was compared between the two groups.Results:All the pa-tients underwent the surgery successfully.No serious complications such as spinal cord injury or infection oc-curred.There were no significant differences in operation time,intraoperative blood loss,postoperative drainage volume between the two groups(P＞0.05).The neck pain VAS scores,NDI and JOA scores in both groups showed significant improvement immediately after surgery,2 months after surgery,and at final follow-up(P＜0.05).There were no differences in neck pain VAS scores and NDI between the two groups at preoperation,immediately after surgery,2 months after surgery and final follow-up(P＞0.05).There was no statistical differ-ence in preoperative JOA scores between the two groups(P＞0.05),but there were statistically significant differ-ences in JOA scores between the two groups immediately after surgery,2 months after surgery,and at final follow-up(P＜0.05).There were no statistical differences in C2-7 Cobb angle,C2-7 SVA,and T1 slope in both groups immediately after surgery,at 2 months after surgery,and at final follow-up,comparing with those before operation(P＞0.05).No significant differences were found between the two groups in C2-7 Cobb angle,C2-7 SVA,and T1 slope at preoperation,immediately after surgery,at 2-month after surgery,and at the fi-nal follow-up(P＞0.05).The average cross-sectional area of the spinal canal in both groups showed significant improvement immediately after surgery,at 2-month after surgery,and at final follow-up(P＜0.05).There was no statistical difference in the preoperative average cross-sectional area of the spinal canal between the two groups(P＞0.05).However,the average cross-sectional area of the spinal canal in the lateral mass group imme-diately after surgery,at 2-month after surgery,and at the final follow-up was larger than that in the conven-tional group,and the differences were statistically significant(P＜0.05).Conclusions:Compared with the con-ventional unilateral open-door cervical laminoplasty,guttering on the lateral mass technique can significantly expand the cross-sectional area of the spinal canal and improve postoperative neurological function recovery.
