Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka,
Spine (Phila Pa 1976). 2009 Dec 15;34(26):2874-9. doi: 10.1097/BRS.0b013e3181bb0e33.
STUDY DESIGN.: Prospective cohort study. OBJECTIVE.: To investigate the recovery process after laminoplasty in patients with cervical myelopathy, and the effects of patient age and duration of symptoms before surgery on the recovery process. SUMMARY OF BACKGROUND DATA.: The surgical results of laminoplasty for cervical myelopathy have been well documented, but there have been few reports on the recovery process after cervical laminoplasty. METHODS.: The study group consisted of 98 patients who underwent double-door laminoplasty for cervical myelopathy. All cases were followed for a minimum of 5 years. The JOA score, 10 seconds grip and release test (10-second test), and grasp strength were evaluated at "fixed points" after surgery, and the recovery process in each subject was assessed. The maximum recovery time point, defined as the time point when the value just reached a plateau after surgery, was evaluated in each subject.Patients were divided into 2 groups by age (<70 years and > or = 70 years) or duration of symptoms before surgery (<1 year and > or = 1 year), and the effects of these factors on surgical results were investigated. RESULTS.: The preoperative values of all parameters significantly improved 5 years after surgery. The JOA score reached a plateau earlier (8.7 months) than did the grasp strength (21.7 months) and 10-second test (25.6 months). The maximum recovery time point of the JOA score was statistically late in the elder group (> or =70 years) compared to the younger group (<70 years). The recovery rates of the JOA score and the degree of recovery for the 10-second test in patients with symptoms lasting <1 year were statistically greater than those in patients with symptoms lasting > or =1 year. CONCLUSION.: The functional status assessed by the JOA score recovered within 1 year after surgery but further recovery can be expected up to 2 years after surgery. The comparative study suggested that patient age influenced the process of recovery, and the duration of symptoms before surgery influenced the degree of recovery.
前瞻性队列研究。目的：探讨颈椎脊髓病患者接受椎板成形术后的恢复过程，以及患者年龄和术前症状持续时间对恢复过程的影响。背景资料概要：椎板成形术治疗颈椎脊髓病的手术效果已有充分记录，但关于颈椎椎板成形术后恢复过程的报道较少。方法：研究组由 98 例因颈椎脊髓病接受双开门椎板成形术的患者组成。所有病例均随访至少 5 年。术后在“固定点”评估日本骨科协会（JOA）评分、10 秒握力和释放试验（10 秒试验）以及握力，并评估每位患者的恢复过程。在每位患者中评估最大恢复时间点，定义为术后刚好达到平台期的时间点。根据年龄（<70 岁和≥70 岁）或术前症状持续时间（<1 年和≥1 年）将患者分为 2 组，研究这些因素对手术结果的影响。结果：所有参数的术前值在术后 5 年时均显著改善。JOA 评分达到平台期的时间早于握力（8.7 个月）和 10 秒试验（25.6 个月）。JOA 评分的最大恢复时间点在老年组（≥70 岁）比年轻组（<70 岁）晚。症状持续时间<1 年的患者的 JOA 评分和 10 秒试验恢复程度的恢复率显著大于症状持续时间≥1 年的患者。结论：术后 1 年内通过 JOA 评分评估的功能状态得到恢复，但术后 2 年内仍可期待进一步恢复。对比研究表明，患者年龄影响恢复过程，术前症状持续时间影响恢复程度。
