Effect of Limited Laminectomy Combined with Foraminal Stenosis Decompression on Preventing C5Palsy / 中国康复理论与实践

ABSTRACT

@#Objective To observe the effect of limited laminectomy combined with foraminal stenosis decompression on preventing C5nerve root palsy and improving neurological function. Methods From March,2014 to May,2016,69 patients with multi-segment cervical spondylotic myelopathy underwent surgical treatment in our hospital were included.Thirty-eight patients(group A)were treated with limited lami-nectomy combined with foraminal stenosis decompression and internal fixation,and 31 patients(group B)under-went routine laminectomy and internal fixation.The postoperative neurological recovery rate,cervical curvature index(CCI)and C5palsy rate were recorded and analyzed. Results No spinal cord and nerve injury occurred during the operation.The width of laminectomy was(16.8±2.1)mm in group A,and was significantly less than(21.7±2.5)mm in group B(t=8.849,P<0.001).There was no significant difference in operation time and intraoperative blood loss between two groups(t<0.439,P>0.05).The Japanese Orthopaedic Association (JOA) score increased continuously after surgery in both groups (F>42.996, P<0.05), and no significant difference was found between them at each time point(t<1.021,P>0.05).The cervical curva-ture index improved after surgery(F>86.379,P<0.05),and no significant difference was found between them at each time point(t<0.943,P>0.05).The spinal cord drift distance was(3.6±0.7)mm in group A,and ws signifi-cantly shorter than(2.5±0.5)mm in group B(t=7.602,P<0.001).There was no significantly difference in the neu-rological recovery rate between two groups(t=0.724,P=0.471).The C5palsy rate was lower in group A(5.2%,2/38)than in group B(22.5%,7/31)(χ2=4.514,P=0.034). Conclusion Limited laminectomy combined with foraminal stenosis decompression could relieve the spinal cord com-pression and restrict the excessive back drift, promote the neurological function recovery and reduce the inci-dence of C5palsy.