Department of Neurosurgery, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Faculty of Gülhane Medicine, University of Health Sciences, Ankara, Turkey
Neurosurgery Clinic, Yozgat City Hospital, Ministry of Health, Yozgat, Turkey
Turk J Med Sci. 2021 Dec 13;51(6):2887-2896. doi: 10.3906/sag-2102-308.
BACKGROUND/AIM: Cervical spondylotic myelopathy (CSM) develops as a result of compression of the spinal cord in the cervical region. Early diagnosis and surgical treatment can limit the progression of symptoms. Various surgical approaches and strategies have been described in the literature. This study aims to evaluate the clinical and radiological results of open-door laminoplasty for the treatment of CSM.
In this study, we retrospectively analyzed the patients who underwent expansive open-door laminoplasty secured with titanium miniplates. Thirty-four patients with CSM who were followed up postoperatively for more than 12 months were included in the study. The modified Japanese Orthopaedic Association (mJOA) score was used to assess the degree of myelopathy. We evaluated cervical sagittal alignment with C2–C7 Cobb angle, the ambulatory status with the Nurick grade, and measured postoperative neck pain with the visual analogue scale (VAS).
Themeanm JOA score was 11 (range 6–15) preoperatively, and 13.5 (range 9–16) postoperatively with an average 55% recovery rate (range 0–75) (p < 0.001). Themean–Nurick grade was 2 (range 1–3) preoperatively and 1 (range 0–3) postoperatively (p < 0.001). The median cervical lordotic angle increased from 7.5 ° preoperatively to 12.5 ° postoperatively (p = 0.044). K-line (+) patients› mean mJOA scores significantly increased from 10.8 ± 1.7 to 13.3 ± 1.7 postoperatively (p < 0.001). The mean preoperative VAS reduced from 2.66 ± 1.4 to 1.59 ± 1.4 postoperatively (p < 0.001).
Open-door laminoplasty technique is an effective surgical procedure that can be used safely to treat cervical spondylotic myelopathy. Our findings suggest that it can limit the progression of symptoms and alter the poor prognosis in CSM.
背景/目的：颈椎脊髓病（CSM）是由于颈椎区域脊髓受压而发展的。早期诊断和手术治疗可以限制症状的进展。文献中已经描述了各种手术方法和策略。本研究旨在评估颈椎后路单开门椎管扩大成形术治疗 CSM 的临床和影像学结果。
本研究回顾性分析了接受钛制微型板固定的颈椎后路单开门椎管扩大成形术治疗的 CSM 患者。纳入研究的 34 例 CSM 患者术后随访时间超过 12 个月。采用改良日本矫形协会（mJOA）评分评估脊髓病程度。我们使用 C2–C7 Cobb 角评估颈椎矢状位排列，使用 Nurick 分级评估活动状态，使用视觉模拟量表（VAS）评估术后颈部疼痛。
术前 mJOA 评分为 11 分（6-15 分），术后 13.5 分（9-16 分），平均恢复率为 55%（0-75%）（p < 0.001）。术前 Nurick 分级平均为 2 级（1-3 级），术后 1 级（0-3 级）（p < 0.001）。颈椎前凸角中位数从术前 7.5°增加到术后 12.5°（p = 0.044）。K 线（+）患者的 mJOA 评分从术前 10.8 ± 1.7 分显著增加到术后 13.3 ± 1.7 分（p < 0.001）。术前 VAS 平均值从 2.66 ± 1.4 分降至术后 1.59 ± 1.4 分（p < 0.001）。
颈椎后路单开门椎管扩大成形术是一种安全有效的手术方法，可用于治疗颈椎脊髓病。我们的研究结果表明，它可以限制症状的进展并改变 CSM 的不良预后。
