Cho Sung Hoon, Lee Jung Hwan, Chough Chung Kee, Joo Won Il, Park Hae Kwan, Lee Kyung Jin, Rha Hyoung Kyun
Catholic Neuroscience Center, Department of Neurosurgery, Yeouido St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea.
Korean J Spine. 2014 Jun;11(2):45-51. doi: 10.14245/kjs.2014.11.2.45. Epub 2014 Jun 30.
The purpose of this study was to determine whether the status of the hinge gutter affected clinical and radiographic outcomes of cervical open door laminoplasty.
We retrospectively analyzed 43 patients who had undergone cervical open door laminoplasty. 23 CT scans were performed at 2 days post-operation. The number of CT scans at 3, 6, 12 and 24 months were 16, 12, 21 and 11, respectively. We collected perioperative and follow-up data, including clinical and radiographic results.
There were 7 patients without a hinge fracture and 16 patients with one or more hinge fractures at 2 days postoperation. There were 90 hinges, and the rate of ideal greenstick deformation of the hinge was 63% on 2-day-postoperative CT scans. Postoperative VAS scores of neck pain (p=0.012) in patients without a hinge fracture were higher than in patients with hinge fractures. The hinge healing rates were 37% at 3 months, 57.4% at 6 months, 86.4% at 12 months, and 85.4% at 24 months. Among the patients, 14 patients had healed hinges, and 7 patients had one or more hinge(s) that was/were not healed at 12 months post-operation. However, in clinical and radiographic outcomes, there was no difference between these patients.
Cervical open door laminoplasty was safe and provided stable reconstruction of laminar expansion. In radiographs, the difference between hinges that had healed and hinges that had not healed was statistically negligible. Hinge fractures might not influence the clinical and radiographic outcomes of cervical open door laminoplasty.
本研究旨在确定铰链沟的状态是否会影响颈椎开门椎板成形术的临床和影像学结果。
我们回顾性分析了43例行颈椎开门椎板成形术的患者。术后2天进行了23次CT扫描。术后3个月、6个月、12个月和24个月的CT扫描次数分别为16次、12次、21次和11次。我们收集了围手术期和随访数据，包括临床和影像学结果。
术后2天，7例患者无铰链骨折，16例患者有一处或多处铰链骨折。共有90个铰链，术后2天CT扫描显示铰链理想青枝骨折率为63%。无铰链骨折患者术后颈部疼痛的视觉模拟评分（VAS）（p = 0.012）高于有铰链骨折的患者。铰链愈合率在3个月时为37%，6个月时为57.4%，12个月时为86.4%，24个月时为85.4%。在这些患者中，14例患者的铰链已愈合，7例患者在术后12个月时有一处或多处铰链未愈合。然而，在临床和影像学结果方面，这些患者之间没有差异。
颈椎开门椎板成形术是安全的，能提供稳定的椎板扩张重建。在X线片上，已愈合的铰链和未愈合的铰链之间的差异在统计学上可忽略不计。铰链骨折可能不会影响颈椎开门椎板成形术的临床和影像学结果。
