Observation on the curative effect of double -door expansive lamino-plasty and artificial bone grafting in treatment of multi -segmental cervical spondylotic myelopathy / 中国现代医生

Objective To summarize and analyze the application value of cervical posterior approach double-door expansive laminoplasty combined with hydroxyapatite artificial bone (HAB) grafting in the treatment of multi -segmental cervical spondylotic myelopathy and its effect on the prognosis of cervical spinal cord injury. Methods 100 patients who underwent cervical posterior approach "double-door" expansive laminoplasty combined with HAB grafting were retrospectively investigated and analyzed. Japanese Orthopaedic Association Scores (JOA) method, X-ray combined with CT examination to observe and determine the expansion rate of average sagittal diameter of the cervical canal, ROM, the ratio of forward inclined type in the type of cervical curvature, the stability of the adjacent intervertebral space, and the state of grafting bone fusion were used to evaluate the clinical efficacy. Results Postoperative JOA scores and mean sagittal diameters of the cervical canal in the most narrow part were significantly improved in all patients; cervical ROM was decreased from preoperative angle of (41. 7±10. 1)0 to (25. 1±11. 3).; the ratio of forward inclined type was decreased by 5％ compared with that before the surgery; the total fusion rate of artificial bone in 5 years was 55. 8％. Symptoms and signs were improved, without local abnormal reactions. The difference was statistically significant (P＜ 0. 05). No intervertebral instability was observed during the follow-up visit. Conclusion The application of HAB for cervical posterior approach double-door laminoplasty is a safe, effective, and postoperatively stable surgical procedure.

Double-door expansive laminoplasty using allogenic bone spacers / 中国矫形外科杂志

[Objective]To study the application of allogenic bone spacer in double-door expansive laminoplasty.[Method]From Apr.2003 to Jun.2004,22 patients underwent double-door expansive laminoplasty using allogenic bone spacers in authors department.All patients were followed up for 16～30 months,with an average time of 18.4 months.JOA scoring system was used to evaluate the neurological status.ROM of cervical spine and bone fusion was determined on X-ray and CT at follow-ups.[Result]At final follow-up,JOA scores improved from(8.3?2.6)points before surgery to(13.3?3.1)points.ROM of cervical spine was reduced from(41.3?10.8)? to(23.4?8.7)?.No postoperative instability happened after operation.Bone fusion between allograft and spinous processes was completed in 69.6%,partial in 23.2% and failed in 7.1% of the operated levels.No breakage and displacement of allograft spacers were found.[Conclusion]Double-door expansive laminoplasty using allogenic bone spacers is safe and effective for cervical spondylotic myelopathy.