Sivaraman Alagappan, Bhadra Arup K, Altaf Farhaan, Singh Anoushka, Rai Amarjit, Casey Adrian T, Crawford Robert J
Royal National Orthopaedic Hospital, Stanmore, London, UK.
J Spinal Disord Tech. 2010 Apr;23(2):96-100. doi: 10.1097/BSD.0b013e318198c92a.
A prospective nonrandomized study comparing the outcomes of the 2 surgical techniques used in the treatment of cervical spondylotic myelopathy.
We prospectively compared the skip laminectomy and laminoplasty in terms of extent of decompression achieved, axial pain, postoperative range of cervical motion, and patient and surgical outcomes.
Laminoplasty is an established procedure for the decompression of multisegmental cervical compressive myelopathy. However, it often induces postoperative problems, such as axial pain, restriction of neck motion, and loss of lordotic alignment. Skip laminectomy was recently developed as a minimally invasive procedure.
We studied 50 consecutive patients operated on for cervical spondylotic myelopathy and spinal cord compression as demonstrated on magnetic resonance imaging (MRI) between the levels C3-4 and C6-7. Each patient had a minimum follow-up of 2 years (2.2 to 4.3 y). Twenty-five patients underwent skip laminectomy and 25 patients underwent laminoplasty. Decompression was assessed by preoperative and postoperative MRI. Cervical range of motion was assessed by preoperative and postoperative flexion and extension radiographs. Patient outcomes were assessed by evaluation of preoperative and postoperative neurology and SF12 scores for mental health, physical health, and axial pain.
Less blood loss and operative times with skip laminectomy. Similar degrees of decompression with both techniques. Significantly improved axial pain scores with skip laminectomy. Significantly improved preservation of range of movement with skip laminectomy.
Skip laminectomy is an effective procedure for reducing the incidence of postoperative morbidities, such as persisting axial pain, and restriction of neck motion often seen after laminoplasty, and provides adequate decompression of the spinal cord as demonstrated on MRI for a minimum follow-up of 2 years.
一项前瞻性非随机研究，比较用于治疗脊髓型颈椎病的两种手术技术的结果。
我们前瞻性地比较了跳跃式椎板切除术和椎板成形术在减压程度、轴性疼痛、术后颈椎活动范围以及患者和手术结果方面的差异。
椎板成形术是一种用于多节段颈椎压迫性脊髓病减压的既定手术。然而，它常常引发术后问题，如轴性疼痛、颈部活动受限和颈椎生理前凸消失。跳跃式椎板切除术是最近发展起来的一种微创手术。
我们研究了50例因脊髓型颈椎病和磁共振成像（MRI）显示的C3 - 4至C6 - 7节段脊髓受压而接受手术的连续患者。每位患者的最短随访时间为2年（2.2至4.3年）。25例患者接受了跳跃式椎板切除术，25例患者接受了椎板成形术。通过术前和术后MRI评估减压情况。通过术前和术后的屈伸位X线片评估颈椎活动范围。通过评估术前和术后的神经功能以及心理健康、身体健康和轴性疼痛的SF12评分来评估患者的结果。
跳跃式椎板切除术的失血量和手术时间更少。两种技术的减压程度相似。跳跃式椎板切除术的轴性疼痛评分显著改善。跳跃式椎板切除术在活动范围保留方面显著改善。
跳跃式椎板切除术是一种有效的手术方法，可降低术后发病率，如椎板成形术后常见的持续性轴性疼痛和颈部活动受限，并如MRI所示，在最短2年的随访中为脊髓提供充分减压。
