Research and application of cervical vertebral dome expansion laminoplasty / 中华骨科杂志

ABSTRACT

0bjective@#To explore the feasibility and clinical efficacy of cervical vertebral dome expansion laminoplasty..@*Methods@#Our hospital from February 2017 to 2018 Sep 16 cases with cervical spinal canal dome of cervical spinal stenosis angioplasty in treatment of cervical spinal cord due to the medical records of patients, including 14 males and 2 females; Aged 49- 76 years old, average age 57.3±1.7 years old. The course of disease was 7-48 months, with an average disease duration 17.75±1.90 months. Of the 16 patients, 5 had multi-segment cervical disc herniation and 11 had long segmental ossification of the posterior longitudinal ligament. All the 16 patients underwent cervical C3-7 dome-type spinal canal enlargement; the position, stability and spinal cord compression of the internal fixation were evaluated according to the patient's imaging data (X-ray, CT and MRI). The neck and upper extremity pain was evaluated by visual analogue scale (VAS) before and after operation. The cervical spinal cord function was evaluated by the Japanese Orthopaedic Association (JOA) spinal cord function score, and the rate of improvement of neurological function was calculated. The Frankel grading was used to evaluate the neurological function of patients before and after surgery.@*Results@#Cervical X-ray, CT and MRI were performed in all patients before and after surgery. Operation time 55-110 min, mean 65±12 min, bleeding 100-220 ml, mean 110±20 ml. The cross-sectional area of the spinal canal and the median sagittal diameter of the spinal canal were significantly increased compared with the preoperative. All patients were followed up for an average of 10.9±1.4 months (3-20 months). Imaging examination showed that 16 patients had no loosening and fracture after internal fixation, and no re-closure occurred. MRI T2WI images showed continuous recovery of cerebrospinal fluid signal in the spinal cord of C3-7 range. The preoperative VAS score was 7.3±0.9 points, the average VAS score at the last follow-up was 1.6±0.4 points, the preoperative JOA score was 6.9±1.1 points, and the last follow-up JOA score was 13.4±1.3 points. The improvement rate was 87.23%±3.81%; Frankel grade D before surgery, and Frankel grade E after surgery.@*Conclusion@#Cervical spinal canal domed simple angioplasty operation, spinal canal full, satisfactory clinical efficacy, and can effectively reduce the incidence of related complications, it is a safe and feasible method for the treatment of cervical spinal stenosis.