Hosono N, Sakaura H, Mukai Y, Fujii R, Yoshikawa H
Department of Spine Surgery, Osaka Kosei-Nenkin Hospital, Osaka, Japan.
Eur Spine J. 2006 Sep;15(9):1375-9. doi: 10.1007/s00586-006-0089-9. Epub 2006 Mar 18.
Five-lamina (C3-7) procedure is the most popular cervical laminoplasty and there have been no studies on the most appropriate number of laminae to be opened. We prospectively reduced the range of laminoplasty from C3-7 to C3-6 in 2002 and compared the outcome of C3-6 laminoplasty (n=37) to that of C3-7 laminoplasty (n=28). In both groups, neurological gain was satisfactory, radiographic changes were minimal, and postoperative MRI indicated sufficient expansion of the dura and the spinal cord. Average operating period was significantly shorter, and length of the operative wound was significantly less in the C3-6 group than in the C3-7 group. Postoperative axial neck pain was significantly rarer after C3-6 laminoplasty than after C3-7 laminoplasty (5.4% vs. 29%, P=0.015). Due to its simplicity and various benefits, C3-6 laminoplasty is a promising alternative to conventional C3-7 laminoplasty for treatment of multisegmental compression myelopathy.
五椎板(C3 - 7)手术是最常用的颈椎椎板成形术,目前尚无关于最合适椎板切开数量的研究。2002年,我们前瞻性地将椎板成形术的范围从C3 - 7缩小至C3 - 6,并比较了C3 - 6椎板成形术(n = 37)与C3 - 7椎板成形术(n = 28)的效果。两组患者神经功能改善均令人满意,影像学改变轻微,术后MRI显示硬脑膜和脊髓有足够的扩张。C3 - 6组的平均手术时间明显更短,手术切口长度明显小于C3 - 7组。C3 - 6椎板成形术后轴性颈痛明显少于C3 - 7椎板成形术(5.4%对29%,P = 0.015)。由于其操作简单且具有多种益处,C3 - 6椎板成形术是治疗多节段压迫性脊髓病的一种有前景的替代传统C3 - 7椎板成形术的方法。