Influence of preoperative C7/T1 foraminal area on the efficacy of posterior cervical laminoplasty in the treatment of cervical spondylotic myelopathy
10.3969/j.issn.1004-406X.2024.05.02
- VernacularTitle:术前C7/T1椎间孔面积对后路单开门椎管扩大成形术治疗脊髓型颈椎病疗效的影响
- Author:
Lilong ZHANG
1
;
Rui SHAO
;
Yannan GENG
Author Information
1. 天津市人民医院脊柱脊髓病诊疗中心 300122
- Keywords:
Cervical spondylotic myelopathy;
C7/T1 foraminal area;
Posterior cervical open-door laminoplas-ty;
Axial symptoms
- From:
Chinese Journal of Spine and Spinal Cord
2024;34(5):458-462
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To investigate the effects on the efficacy of posterior cervical laminoplasty in patients with cervical spondylotic myelopathy of different C7/T1 foraminal areas before surgery.Methods:76 patients who underwent posterior cervical open-door expansive laminoplasty for cervical spondylotic myelopathy in our hospital from September 2021 to September 2022 were analyzed retrospectively,including 58 males and 18 females,aged 64.4±8.5 years old.The area of C7/T1 foramina of patients was measured on the double oblique X-ray images before operation,and the patients were divided into two groups on the basis of the av-erage C7/T1 foraminal area:Group A,C7/T1 foraminal area ≤average value(40 patients),and group B,C7/T1 foraminal area＞average value(36 patients).The operative time and intraoperative bleeding were collected and compared between groups,and the Japanese Orthopaedic Association(JOA)scores before surgery,3 months af-ter surgery,and 12 months after surgery were obtained to calculate the JOA score improvement rate;The axi-al symptoms at 12 months after surgery were recorded,and T test,analysis of variance,and chisquare test were used to analyze whether different preoperative C7/T1 forminal areas of patients affected the efficacies after posterior cervical laminoplasty.Results:The foraminal areas of C7/T1 was 35.2±9.7mm2 in group A and 65.7±13.1mm2 in group B,and C2-C7 Cobb angle before operation was 14.0°±3.6° in group A and 16.0°±5.5° in group B,with statistical differences respectively(P＜0.05).Group A was not significantly different from group B in terms of intraoperative bleeding(176.8±88.2mL vs 183.6±100.2mL)and operative time(127.5±23.6min vs 120.3±32.6min)(P＞0.05).The JOA scores of group A and group B were 10.9±2.0 and 10.3±2.1 before operation,without statistical difference(P＞0.05);The JOA scores of group A and group B were 12.8±1.5 and 14.0±2.2 at postoperative 3 months and 14.1±1.5 and 15.9±1.7 at 12 months after operation,with statistical differences respectively(P＜0.05).There were statistical differences in the improvement rates of JOA scores between the two groups at postoperative 3 months and 12 months,respectively(P＜0.05).The incidence of axial symptoms 12 months after operation in group A and group B was 42.5％and 19.4％,respectively,with statistical difference(P＜0.05).Conclusions:Patients with larger C7/T1 foraminal area have better postoperative neurological recovery,higher rate of JOA improvement,and lower incidence of postoperative axial symptoms.
