Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology, Orthopaedic Research Institute, Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Biomed Res Int. 2020 Dec 7;2020:8853733. doi: 10.1155/2020/8853733. eCollection 2020.
To compare the five-year surgical outcomes between Open-Door laminoplasty (ODL) and French-Door laminoplasty (FDL) in the management of multilevel cervical spondylotic myelopathy (MCSM).
Sixty patients with MCSM, who were operated by ODL or FDL, were included in this study and followed up for at least 5 years. The average follow-up period was 69.2 ± 3.2 months. The modified Japanese Orthopaedic Association (mJOA) score and radiological assessments including the Cobb angle and cervical range of motion (ROM) were evaluated and compared before surgery and at the final follow-up. The incidence of postoperative complications and medical costs were also compared.
Both ODL and FDL groups achieved significant improvements of the mJOA score in postoperative 5 years; the average recovery rate (RR) of the mJOA score in the ODL and FDL groups was 72.14 ± 6.97% and 69.53 ± 7.51%, respectively. No statistically significant differences regarding the pre- and postoperative mJOA score, the RR of the mJOA score, the loss and the loss rate of the Cobb angle, and the incidence of postoperative complications existed between ODL and FDL. The mean loss and the loss rate of cervical ROM in the FDL group (18.70 ± 8.91°, 41.08 ± 11.17%) were significantly higher than those of the ODL group (13.81 ± 8.62°, 31.47 ± 12.43%) ( < 0.05). FDL reduced medical costs more greatly than ODL (33014.37 ± 3424.12 China Yuan versus 82096.62 ± 7093.07 China Yuan, < 0.001).
Both ODL and FDL are effective for MCSM. The 5-year neurological results are similar between the two groups. ODL trends to be superior to FDL in postoperative preservation of cervical ROM while FDL reduced medical costs more greatly.
比较开门式椎板成形术（ODL）和法式开门式椎板成形术（FDL）治疗多节段脊髓型颈椎病（MCSM）的 5 年手术效果。
本研究纳入了 60 例接受 ODL 或 FDL 手术治疗的 MCSM 患者，并进行了至少 5 年的随访。平均随访时间为 69.2 ± 3.2 个月。在术前和末次随访时，评估并比较改良日本骨科协会（mJOA）评分和影像学评估，包括 Cobb 角和颈椎活动度（ROM）。还比较了术后并发症和医疗费用的发生率。
ODL 和 FDL 组在术后 5 年均显著改善了 mJOA 评分；ODL 和 FDL 组 mJOA 评分的平均恢复率（RR）分别为 72.14 ± 6.97%和 69.53 ± 7.51%。ODL 和 FDL 组在术前和术后 mJOA 评分、mJOA 评分 RR、Cobb 角丢失和丢失率以及术后并发症发生率方面均无统计学差异。FDL 组颈椎 ROM 的平均丢失和丢失率（18.70 ± 8.91°，41.08 ± 11.17%）明显高于 ODL 组（13.81 ± 8.62°，31.47 ± 12.43%）（ < 0.05）。FDL 比 ODL 显著降低了医疗费用（33014.37 ± 3424.12 元人民币比 82096.62 ± 7093.07 元人民币， < 0.001）。
ODL 和 FDL 对 MCSM 均有效。两组患者术后 5 年的神经学结果相似。在术后颈椎 ROM 的保持方面，ODL 趋势优于 FDL，而 FDL 显著降低了医疗费用。
