Extended to C1, 2 spinal posterior cervical open-door expansion of the angioplasty treatment combined with cervical spinal stenosis / 中华骨科杂志

ABSTRACT

Objective To explore the surgical method and effects of posterior expansive open-door laminoplasty extended to C1,2 levels.Methods 16 cervical spinal stenosis patients with cervical myelopathy were posterior cervical surgery in our hospital from February 2013 to September 2015,including 11 males and 5 females;aged 51-76,average 62.8.4 cases merged C1spinal stenosis,the line which operated by C1～7 spinal posterior open-door expansion of the forming with mini titanium fixation;12 cases merged C2 spinal stenosis,which had the operation of C2～7 posterior open-door laminoplasty with Micro Titanium fixation plate.According to the patient imaging data to assess the stability of the cervical spine,and spinal cord compression fixation position before and after their surgery evaluated;the preoperative and postoperative pain using visual analog scale (VAS);application Japanese Orthopaedic Association (JOA) score spinal cord score was used to evaluated spinal cord function,and calculates the rate of improvement of neurological function;surgery patients before and after application Frankel grading was used to evaluate neurological function.Results All patients were followed up,for an average of 11.58 months (2-33 months).16 patients showed no loosening,fracture fixation and related complications,C1,2 showed no instability;cerebrospinal fluid surrounding the spinal cord with in the C1-7 range of the signal on MRI T2WI showed continuous recovery;preoperative VAS score was 6.7 points,postoperative VAS score was 1.8 points;the first 16 cases of patients with preoperative JOA score average (8.3± 1.6) points,postoperative JOA score was (14.6±1.4) points,postoperative neurological improvement rate was 91.6％;Frankel grade C before operation and grade E in postoperation;postoperative follow-up neurological improvement rate excellent 7 cases,good 7 cases,general 2 cases.Conclusion Treatment of cervical spinal stenosis combined with cervical myelopathy may use a C 1-7 posterior spinal expand within the single door molding fixation with mini titanium plate,which can release the compression of the cervical spinal cord nerve and reconstruct a stable structure of posterior of cervical spine.