Kang Suk-Hyung, Rhim Seung-Chul, Roh Sung-Woo, Jeon Sang-Ryong, Baek Hyun-Chul
Department of Neurological Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Neurosurg Spine. 2007 May;6(5):386-90. doi: 10.3171/spi.2007.6.5.386.
The authors studied cervical range of motion (ROM) before and after cervical laminoplasty to determine factors associated with cervical ROM in patients with cervical myelopathy.
Between July 2003 and August 2005, 20 patients underwent a modified Hirabayashi-type unilateral open-door laminoplasty to treat multilevel cervical spondylosis or ossification of the posterior longitudinal ligament (OPLL). Clinically, the authors assessed Japanese Orthopaedic Association (JOA) score, duration of symptoms, disease entity, and the age and sex of patients to ascertain the relation of these factors to ROM before and after cervical laminoplasty. Intraoperative findings such as ligament detachment from the C-2 spinous process and cervicothoracic junction involvement were noted. Radiological and imaging findings such as the length of the lesion, cervical axial canal area, anteroposterior (AP) diameter of the cervical canal, angle of the opened lamina after surgery, cervical sagittal angles, cervical curvature index (CCI), and signal change of the cord on magnetic resonance imaging were evaluated. The mean follow-up period was 19.45 months (range 13-38 months). The preoperative average ROM in 18 patients (after excluding two patients with trauma) was 36.73 +/- 15.73 degrees; postoperatively it was 25.24 +/- 16.06 degrees. Thus, ROM decreased by 9.64 +/- 10.09 degrees (31.80%) after surgery (p = 0.002), reflecting the mean in the same 18 patients. Preoperative ROM was related to the age of patients, CCI, preoperative JOA score, and AP diameter of the cervical canal. In cases of OPLL the ROM was lower than that in cases of spondylosis. Postoperative cervical ROM was related to preoperative ROM, postoperative AP diameter of the cervical canal, laminar angle, patient age, and follow-up duration. None of the studied parameters, however, correlated with a decreased cervical ROM.
Cervical ROM was reduced after cervical laminoplasty. Postlaminoplasty cervical ROM had a positive correlation with extended motion; however, gradually it became reduced. In this study, no correlative factor was associated with a reduction in cervical ROM. Further study is also needed.
作者研究了颈椎板成形术前和术后的颈椎活动度（ROM），以确定与脊髓型颈椎病患者颈椎ROM相关的因素。
在2003年7月至2005年8月期间，20例患者接受了改良平林式单侧开门颈椎板成形术，以治疗多节段颈椎病或后纵韧带骨化症（OPLL）。临床上，作者评估了日本骨科协会（JOA）评分、症状持续时间、疾病类型以及患者的年龄和性别，以确定这些因素与颈椎板成形术前和术后ROM的关系。记录术中所见，如C-2棘突韧带松解和颈胸段受累情况。评估放射学和影像学表现，如病变长度、颈椎管面积、颈椎管前后径、术后开门角度、颈椎矢状角、颈椎曲度指数（CCI）以及磁共振成像上脊髓的信号变化。平均随访期为19.45个月（范围13 - 38个月）。18例患者（排除2例创伤患者后）术前平均ROM为36.73±15.73度；术后为25.24±16.06度。因此，术后ROM降低了9.64±10.09度（31.80%）（p = 0.002），反映的是同一18例患者的平均值。术前ROM与患者年龄、CCI、术前JOA评分以及颈椎管前后径相关。在OPLL病例中，ROM低于颈椎病病例。术后颈椎ROM与术前ROM、术后颈椎管前后径、椎板角度、患者年龄和随访时间相关。然而，所研究的参数均与颈椎ROM降低无关。
颈椎板成形术后颈椎ROM降低。颈椎板成形术后颈椎ROM与伸展运动呈正相关；然而，随后逐渐降低。在本研究中，没有相关因素与颈椎ROM降低有关。还需要进一步研究。
