Protopsaltis Themistocles S, Choi Christine E, Kaplan Daniel J
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.
J Spinal Disord Tech. 2015 Nov;28(9):319-23. doi: 10.1097/BSD.0000000000000323.
Cervical spondylotic myelopathy (CSM) is a condition resulting from cervical stenosis. Manifestations of CSM include paresthesia in the extremities, loss of fine motor skills, balance problems, and bowel and bladder dysfunction in advanced disease. Laminoplasty is one surgical treatment option. The goal of laminoplasty is to reposition the laminae to expand the spinal canal, allowing the spinal cord to migrate posteriorly. There are various laminoplasty techniques; the main ones being open-door laminoplasty and double-door laminoplasty. This manuscript demonstrates a double-door laminoplasty otherwise known as a "French-door" laminoplasty discusses the indications and outcomes of this procedure.
The double-door laminoplasty creates an opening in the midline of the spinous processes and a symmetrical expansion with hinges on both laminae. Bilateral troughs are drilled on each laminae using a bur, and opened liked a French-door, allowing the spinal cord to move posteriorly in the enlarged spinal canal. The space between the gapped laminae are then stabilized by allograft.
This manuscript presents the case of a 56-year-old man with CSM caused by multilevel cervical stenosis. The patient had classic signs and symptoms of CSM including problems with fine motor skills and walking difficulty. The video demonstrates the spinal cord decompression achieved with the French-door technique from C4 to C6 with a dome laminectomy at C3.
There are many surgical treatments for cervical stenosis including anterior cervical discectomy and fusions and posterior procedures such as laminoplasty or laminectomy and fusion. The indications and technical pearls for French-door laminoplasty are presented as an effective option for the treatment of multilevel cervical stenosis.
脊髓型颈椎病（CSM）是一种由颈椎管狭窄引起的病症。CSM的表现包括肢体感觉异常、精细运动技能丧失、平衡问题以及晚期疾病中的肠道和膀胱功能障碍。椎板成形术是一种手术治疗选择。椎板成形术的目标是重新定位椎板以扩大椎管，使脊髓向后移动。有多种椎板成形术技术；主要的是单开门椎板成形术和双开门椎板成形术。本文展示了一种双开门椎板成形术，也称为“法式门”椎板成形术，并讨论了该手术的适应症和结果。
双开门椎板成形术在棘突中线处制造一个开口，并在两个椎板上形成带铰链的对称扩张。使用骨钻在每个椎板上钻出双侧槽，然后像法式门一样打开，使脊髓在扩大的椎管中向后移动。然后用同种异体骨稳定椎板间隙。
本文介绍了一名56岁因多节段颈椎管狭窄导致CSM的男性病例。患者具有CSM的典型体征和症状，包括精细运动技能问题和行走困难。视频展示了通过“法式门”技术从C4至C6实现脊髓减压，并在C3处进行了穹窿状椎板切除术。
颈椎管狭窄有多种手术治疗方法，包括前路颈椎间盘切除融合术和后路手术，如椎板成形术或椎板切除融合术。“法式门”椎板成形术的适应症和技术要点作为治疗多节段颈椎管狭窄的有效选择被呈现出来。
