Gu Yong-Jie, Hu Yong, Ma Wei-Hu, Xu Rong-Ming, Zhao Hong-Yong
Department of Spinal Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China.
Zhongguo Gu Shang. 2012 Sep;25(9):726-9.
To explore the clinical application of Centerpiece titanium plate fixation in open door laminoplasty.
From January 2009 to December 2010,25 patients with cervical spinal stenosis were treated by open door laminoplasty with Centerpiece titanium plate fixation. There were 16 males and 9 females,with a mean age of (57.2 +/- 6.7) years (ranged, 44 to75 years). There were multilevel cervical myelopathy in 8 cases, posterior longitudinal ligament ossification in 12 cases and congenital cervical spinal stenosis in 5 cases. According to Japanese Orthopedic Association (JOA) score to evaluate nerve function and calculate improvement rate. X-ray and CT were used to evaluate postoperative spinal canal enlargement and bone fusion at the hinge side. The sagittal diameter of C5 spinal canal on the lateral X-ray was measured before operation and 6 months after operation respectively, and the expansion rate of spinal canal was calculated [(postoperative sagittal diameter-preoperative sagittal diameter)/(preoperative sagittal diameter) x 100%].
The operative time and intraoperative blood loss were respectively (165.5 +/- 35.6) min and (325.0 +/- 75.1) ml. All patients were followed up from 6 to 18 months with an average of (7.3 +/- 3.8) months. The JOA score increased from 9.3 +/- 1.1 before operation to 14.7 +/- 2.1 at 6 months after operation (t = 4.12, P < 0.05), and the improvement rate was (64.5 +/- 10.2)%. Radiographic data showed spinal canal enlarged perfectly, bone fusion at hinge side and no cervical spinal stenosis was found. The sagittal diameter of C5 spinal canal improved from (9.0 +/- 1.5) mm before operation to (14.3 +/- 2.0) mm at 6 months after operation (t = 7.61, P < 0.05), and the expansion rate was (67.6 +/- 11.8)%.
Clinical application of Centerpiece titanium plate fixation in open door laminoplasty is safe and effective. While vertebral plate is elevated to obtain instantly stability, at the same time, the integrity of spinal canal is also recovered.
探讨Centerpiece钛板固定在开门式椎板成形术中的临床应用。
2009年1月至2010年12月，对25例颈椎管狭窄症患者采用Centerpiece钛板固定行开门式椎板成形术治疗。其中男性16例，女性9例，平均年龄（57.2±6.7）岁（范围44至75岁）。多节段颈椎病8例，后纵韧带骨化12例，先天性颈椎管狭窄5例。根据日本骨科协会（JOA）评分评估神经功能并计算改善率。采用X线和CT评估术后椎管扩大情况及铰链侧骨融合情况。分别于术前及术后6个月测量颈椎侧位X线片上C5椎管矢状径，并计算椎管扩大率[（术后矢状径-术前矢状径）/术前矢状径×100%]。
手术时间及术中出血量分别为（165.5±35.6）分钟和（325.0±75.1）毫升。所有患者随访6至18个月，平均（7.3±3.8）个月。JOA评分由术前的9.3±1.1提高至术后6个月的14.7±2.1（t = 4.12，P < 0.05），改善率为（64.5±10.2）%。影像学资料显示椎管扩大良好，铰链侧骨融合，未发现颈椎管狭窄。C5椎管矢状径由术前的（9.0±1.5）毫米改善至术后6个月的（14.3±2.0）毫米（t = 7.61，P < 0.05），扩大率为（67.6±11.8）%。
Centerpiece钛板固定在开门式椎板成形术中的临床应用安全有效。在抬起椎板获得即时稳定性的同时，也恢复了椎管的完整性。
