Sasai K, Saito T, Akagi S, Kato I, Ogawa R
Department of Orthopaedic Surgery, Kansai Medical University, Osaka, Japan.
J Spinal Disord. 2000 Feb;13(1):26-30. doi: 10.1097/00002517-200002000-00005.
To assess the consequences of cervical laminoplasty on postoperative lordosis, a retrospective radiographic analysis of 31 patients undergoing laminoplasty for spondylotic myelopathy was completed. Special attention was paid to lordotic changes occurring at each level over more than 2 years. Preoperative lordosis remained unchanged with the patients wearing a cervical orthosis 1 week postoperatively. However the lordosis subsequently demonstrated a significant decrease in 87% of patients over an average of 3.1 years. Lordotic alignment at C2-C3 and C6-C7 before surgery significantly decreased in 81% and 58% of patients 1 week postoperatively, and 84% and 81% at last follow up, respectively, while lordotic alignment at other levels pre- and postoperatively did not significantly change. Loss of lordotic alignment was largely attributed to detachment of semispinalis cervicis muscle on C2 and nuchal ligament on C6/C7 with a posterior approach and/or section of yellow ligament at C2-C3.
为评估颈椎椎板成形术对术后脊柱前凸的影响，我们对31例行椎板成形术治疗脊髓型颈椎病的患者进行了回顾性影像学分析。特别关注了超过2年时间里每个节段发生的脊柱前凸变化。术后1周佩戴颈托时患者的术前脊柱前凸保持不变。然而，随后平均在3.1年的时间里，87%的患者脊柱前凸显著下降。术前C2-C3和C6-C7节段的脊柱前凸排列在术后1周分别有81%和58%的患者显著下降，在末次随访时分别为84%和81%，而其他节段术前和术后的脊柱前凸排列无显著变化。脊柱前凸排列的丧失主要归因于后路手术时C2节段的颈半棘肌和C6/C7节段的项韧带分离和/或C2-C3节段的黄韧带切断。
