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钛笼辅助颈椎开门椎板成形术后的临床结果与影像学表现

Clinical outcome and radiological findings after cervical open door laminoplasty with titanium basket.

作者信息

Matsuoka Hidenori, Ohara Yukoh, Kimura Takaoki, Kikuchi Nahoko, Nakajima Yasuhiro, Mizuno Junichi

机构信息

Center for Less Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kawasaki, Japan.

Center for Less Invasive Spinal Surgery, Shin-Yurigaoka General Hospital, Kawasaki, Japan; Department of Neurosurgery, Juntendo University, Tokyo, Japan.

出版信息

J Clin Neurosci. 2020 Mar;73:140-143. doi: 10.1016/j.jocn.2019.12.065. Epub 2020 Jan 24.

Abstract

OBJECT

Cervical laminoplasty, which is well described in the Japanese literature, is the gold standard for decompressing multilevel spinal cord compression. Several spacers have been introduced to provide enough decompression of the spinal canal and reconstruct the stable posterior elements. The purpose of this study was to retrospectively evaluate radiological outcomes after open door laminoplasty using the titanium spacer (Laminoplasty Basket: L-Basket; Ammtec, Tokyo).

METHODS

Between July 2014 and June 2016, 31 patients with cervical spondylotic disease, including OPLL, were underwent open door laminoplasty with this device. All patients were clinically assessed by JOA score. The average follow-up period was 48.9 months with a range of 37-60 months. Postoperative radiological evaluation revealed bone union on both the open side and the gutter side from 12 months to 36 months after surgery on computed tomography.

RESULTS

The clinical outcome improved from 10.9 points on the Japanese Orthopaedic Association scale to 15.8 points at 3 months after surgery and there were no significant major complications such as the implant failure. The bone union rate of the gutter side was 85.9% (85/99) at 1 year, 96.0% (95/99) at 3 years after surgery and of the open side was 57.6% (57/99) at 1 year, 89.9% (89/99) at 3 years after surgery. Circumferential fusion was confirmed 85.9% (85/99) of the time.

CONCLUSION

This titanium spacer seemed to have the potential of promoting bone union between the spacer and both lamina, and lateral mass in cervical laminoplasty which is a safe procedure with satisfactory clinical results.

摘要

目的

颈椎椎板成形术在日本文献中有详细描述,是治疗多节段脊髓压迫症减压的金标准。已引入多种间隔器以提供足够的椎管减压并重建稳定的后部结构。本研究的目的是回顾性评估使用钛间隔器(椎板成形术篮筐:L-篮筐;Ammtec,东京)进行开门式椎板成形术后的影像学结果。

方法

2014年7月至2016年6月期间,31例颈椎病患者,包括后纵韧带骨化症患者,接受了使用该装置的开门式椎板成形术。所有患者均通过JOA评分进行临床评估。平均随访期为48.9个月,范围为37至60个月。术后影像学评估显示,术后12个月至36个月,计算机断层扫描显示开门侧和沟槽侧均有骨愈合。

结果

日本矫形外科学会量表评分从术前的10.9分提高到术后3个月的15.8分,且未出现如植入物失败等重大并发症。术后1年沟槽侧骨愈合率为85.9%(85/99),3年时为96.0%(95/99);开门侧术后1年骨愈合率为57.6%(57/99),3年时为89.9%(89/99)。85.9%(85/99)的病例实现了环形融合。

结论

这种钛间隔器似乎有促进颈椎椎板成形术中间隔器与椎板及侧块之间骨愈合的潜力,这是一种安全的手术,临床效果令人满意。

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