Stamates Melissa M, Cui Michael X, Roitberg Ben Z
Neurosurgery. 2017 Jun 1;80(6):934-941. doi: 10.1093/neuros/nyw058.
Laminoplasty is an established treatment for cervical myelopathy. Multiple variations have emerged, many advocating the use of allograft, but controversy persists.
To assess medium-term clinical outcomes in patients who underwent laminoplasty with autograft at our institution.
Thirty-two consecutive patients (19 male, 13 female, average age 66 yr) from our prospective outcome registry that underwent cervical laminoplasty between 2009 and 2013 were reviewed. Computed tomography (CT) scan was performed immediately postoperatively and at 6-mo follow-up. Parameters included patient perception of outcome, Nurick score, Neck Disability Index (NDI), visual analog scale for neck pain, and SF-36.
On retrospective analysis, all patients felt improved at 3 mo postoperatively; at 2 yr, this rate was 91%. Improvements were seen in Nurick scores, from 3.16 ± 0.9 preoperatively to 1.94 ± 0.8 at 2 yr; NDI score from 28.7% ± 9% preoperatively to 20.8% ± 9.6% at 2 yr; visual analog scale from 2.8 ± 1.2 preoperatively to 1.7 ± 0.9 at 2 yr; and SF-36 physical component summary from 27.9 ± 10 preoperatively to 37.8 ± 11.9 at 2 yr. All values reached significance at all follow-up points ( P < .05) with the exception of 6-mo NDI values ( P = .062). No C5 palsy, graft complications, or reclosure was observed in any patient during the follow-up period.
Laminoplasty with autograft is a safe and effective method to treat cervical myelopathy, with good medium-term clinical outcome. No reclosures were observed. Bony fusion was seen in all cases on CT scan. Our study found good outcomes in the performance of open-door laminoplasty without hardware, in the treatment of cervical stenosis.
椎板成形术是治疗脊髓型颈椎病的一种成熟方法。已经出现了多种术式，许多人主张使用同种异体移植物，但争议仍然存在。
评估在我院接受自体骨椎板成形术患者的中期临床疗效。
回顾了我院前瞻性结果登记处2009年至2013年间连续接受颈椎椎板成形术的32例患者（男性19例，女性13例，平均年龄66岁）。术后即刻及6个月随访时进行计算机断层扫描（CT）。参数包括患者对结果的感知、Nurick评分、颈部残疾指数（NDI）、颈部疼痛视觉模拟量表和SF-36。
回顾性分析显示，所有患者术后3个月时均感觉症状改善；2年时，这一比例为91%。Nurick评分从术前的3.16±0.9改善至2年时的1.94±0.8；NDI评分从术前的28.7%±9%改善至2年时的20.8%±9.6%；视觉模拟量表评分从术前的2.8±1.2改善至2年时的1.7±0.9；SF-36身体成分总结评分从术前的27.9±10改善至2年时的37.8±11.9。除6个月时的NDI值外（P=0.062），所有随访点的所有数值均具有统计学意义（P<0.05）。随访期间未观察到任何患者出现C5麻痹、移植物并发症或再闭合。
自体骨椎板成形术是治疗脊髓型颈椎病的一种安全有效的方法，中期临床疗效良好。未观察到再闭合情况。CT扫描显示所有病例均有骨融合。我们的研究发现，在治疗颈椎管狭窄时，不使用内固定的开门式椎板成形术效果良好。
