ABSTRACT
Objective To evaluate the clinical outcome of cervical laminoplasty using titanium miniplate ( AO arch) for the treatment of multisegmental cervical spondylotic myelopathy (MCSM).Methods 21 patients with MCSM were operated by cervical posterior unilateral open-door laminoplasty combined with titanium miniplate internal fixation.The JOA score,sagittal diameter of the spinal canal in the midline (SD) and cervical curvature index according to the measurement of Penning method before surgery and at postoperative follow-up intervals were measured and compared by one-way analysis of variance.Results All patients were followed up for 9 ～48 months.There were no severe adverse events.CT sean showed bony fusion at hinge side since six months after operation.According to the JOA score evaluation system,al final follow-up period,9 cases were excellent,7 good,3 ordinary and 2 cases bad.Recovery rate was 62.5 ％ at final follow-up interval.Cervical SD before surgery and in posloperative one month were (9.2 ± 1.1 )mm,(13.5 ± 1.4) mm,respectively.The difference was significant between them( t =3.02,P ＜ 0.01 ),but there was no improvement since one month postoperatively ( P ＞ 0.05 ).Cervical curvature index was ( 12.6 ± 14.7 ) ° preoperatively,it was ( 17.1 ± 12.4 ) ° at final follow-up interval,indicating that cervical curvature index made obvious progress at final follow-up interval ( t =8.26,P ＜ 0.01 ),but there was no significant change within six months postoperatively ( P ＞ 0.05 ).Conclusions Cervical laminoplasty combined with titanium miniplate can enlarge and maintain cervical SD,ameliorate cervical curvature and neurological function,and it is an ideal alternative treatment for MCSM.
ABSTRACT
Objective To explore the stress changes of C7/T1 intervertebral space pre-and post C5/6 discectomy and artificial disc replacement.Method Eleven healthy adult fresh muhisegmental cadaveric cervical spine segments were utilized in this investigation and biomechanically evaluated under the following C5/6 conditions:intact spine,discectomy,and Bryan Disc prosthesis implantation.The load,of neutrality and pure moments of axial,flexion,extension,and lateral bending were applied on each group.The stress changes of the inferior (C7/T1)interverlebral space was detected by modified cyclo-shaped miniature transducer.Result Under axial,anteflexion,and lateral bending loading,the discectomy indicated a significant increase in the stress of the inferiorer(C7/T1)intervertebral space,compared to intact condition and CADR(P＜0.05).Under extension loading,the discectomy indicated an increase in the stress of the inferiorer(C7/T1)intervertebral space,compared to intact condition(P＞0.05).Under axial,flexion,extension and lateral bending loading,the Bryan Disc prosthesis implantation indicate minor increase of the stress in the inferior(C7/T1)intervertebral space to intact condition(P＞0.05).Conclusion There was no difference between the C5/6 ADR and intact spine group.The discectomy of the Cs/6 can increase the stress of the C7/T1 intervertebral spaoe.