Matsuoka Hidenori, Ohara Yukoh, Tomita Yoshiyuki, Kikuchi Nahoko, Hirano Yoshitaka, Uchikado Hisaaki, Mizuno Junichi
Center for Minimally Invasive Spinal Surgery, ShinYurigaoka General Hospital, Kawasaki, Kanagawa 215-0026, Japan.
Spine Section, Department of Neurosurgery, Southern Tohoku Research Institute for Neuroscience, Koriyama, Japan.
Surg Neurol Int. 2017 Sep 7;8:217. doi: 10.4103/sni.sni_204_17. eCollection 2017.
Cervical laminoplasty, utilizing different spacers to ''keep the door open,'' is the gold standard in Japan for treating ossification of the posterior longitudinal ligament (OPLL) and cervical spondylotic myelopathy (CSM). Here, we utilized a novel titanium ''basket'' spacer (Laminoplasty Basket: L-Basket; Ammtec, Tokyo) to perform open door cervical laminoplasty to keep the "door open" while also allowing for bony fusion across the open door.
Twenty-seven patients with/without OPLL were treated with open door laminoplasty utilizing the basket spacer. Patients were analyzed with preoperative/postoperative JOA scores, and X-rays/computed tomography (CT) at least 12 months (range, 12-19 months) postoperatively.
Improvement from the preoperative JOA score of 10.3 points to the postoperative JOA of 14.8 points was noted 3 months postoperatively. There were no complications except one patient who had transient C5 palsy. Twelve months postoperatively, X-rays/CT documented fusion on both the open (62%) and hinge sides (90.2%); circumferential fusion was observed 59.8% of the time.
This titanium "basket" spacer (Laminoplasty Basket: L-Basket; Ammtec, Tokyo) promoted bone union between the spacer and both lamina, lateral masses following cervical laminoplasty without undue complications.
在日本,采用不同的撑开器进行“开门”的颈椎椎板成形术是治疗后纵韧带骨化症(OPLL)和脊髓型颈椎病(CSM)的金标准。在此,我们使用了一种新型钛制“篮式”撑开器(椎板成形术篮式撑开器:L-篮式撑开器;Ammtec,东京)进行开门式颈椎椎板成形术,以保持“开门”状态,同时还能实现开门处的骨融合。
27例有或无OPLL的患者接受了使用篮式撑开器的开门式椎板成形术治疗。对患者进行术前/术后日本骨科协会(JOA)评分分析,并在术后至少12个月(范围为12 - 19个月)进行X线/计算机断层扫描(CT)检查。
术后3个月时,JOA评分从术前的10.3分提高到术后的14.8分。除1例出现短暂性C5麻痹的患者外,无其他并发症。术后12个月,X线/CT显示开门侧(62%)和铰链侧(90.2%)均有融合;59.8%的时间观察到环形融合。
这种钛制“篮式”撑开器(椎板成形术篮式撑开器:L-篮式撑开器;Ammtec,东京)促进了颈椎椎板成形术后撑开器与两侧椎板、侧块之间的骨愈合,且无不当并发症。