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

ABSTRACT

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.