Functional reconstruction of cervical vertebra in patients with cervical spinal stenotic myelopathy through expansive open-door laminoplasty

Zhengxue QUAN; Yunsheng OU; Hong AN

ABSTRACT

BACKGROUND:

The main method to treat cervical spinal stenotic myelopathy caused by various factors is posterior lamninectomy, but the postoperative effect was not satisfactory.

OBJECTIVE:

To observe the postoperative functional reconstruction of the cervical vertebra of the patients with cervical spinal stenotic myelopathy through expansive open-door laminoplasty.

DESIGN:

An observational study by comparing the changes before and after the operation.

SETTING:

Department of Orthopaedics of the First Affiliated Hospital of Chongqing Medical University.

PARTICIPANTS:

Totally 32 patients (22 male and 10 female) with multi-segment cervical spinal stenotic myelopathy were treated at the Department of Orthopaedics of the First Affiliated Hospital of Chongqing Medical University from May 1995 to May 2004. Twelve cases suffered from degenerative spinal canal stenosis caused by spinal cord type of cervical spondylosis, 18 cases suffered from developmental spinal canal stenosis and 2from ossification of cervical posterior longitudinal ligament (OPLL).

METHODS:

Altogether 32 cases were treated through expansive opendoor laminoplasty to the cervical spine. These patients had been followed up for 6 months after the informed consent was obtained. The spinal function was evaluated according to Japanese Orthopaedic Association 17scores before operation, 2 weeks and 3 months after the operation respectively. The radian of the cervical vertebra, the stability of the spinal column and the complications were observed with X-ray.bility of the spinal column and the complications after the operation.

RESULTS:

According to intention-to-treat analysis, all the 32 patients entients before and after the operation According to the evaluation standard stipulated by Japanese Orthopaedic Association (JOA), two weeks and three months after the operation, the scoring of the spinal function was significantly higher in 12 cases of cervical spondylosis myelopathy-induced degenerative stenosis, 18 cases of developmental spinal stenosis and 2 cases of ossification of cervical posterior longitudinal ligament (OPLL)( The score was 5.2, 5.7, 5.5 points respectively before the operation; 9.2, 9.7 , 9.4points respectively 2 weeks after the operation; and 11.3 , 11.8 , 11.6dian of the cervical vertebra, the stability of spinal column, and the complications after the operation Radiographs indicated vanished cervical anteflexion curvature and straightened cervical vertebrae in three cases, but no re-closure or unstable spine happened.

CONCLUSION:

Expansive open-door laminoplasty for cervical spinal canal stenosis caused by various factors can still improve and increase the spinal functional evaluation scores shortly and 3 months after the operation, and it does not affect the stability of the cervical vertebrae.