Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, Kyung HeeUniversity, Seoul, Republic of Korea.
Sci Rep. 2023 Feb 4;13(1):2062. doi: 10.1038/s41598-023-28490-7.
Surgeons should select one side for cervical unilateral open door laminoplasty (UODL). However, few reports suggest proper guidelines for deciding which side to open. The aim of this study is to evaluate the impact of opening side in UODL on dominant cord compressive or symptomatic side. 193 degenerative cervical myeloradiculopathy patients with followed-up more than 2 years were enrolled. In all cases, UODL was performed uniformly on the right side. Patients were sub-grouped based on preoperative dominant 3 characteristics: cord compression, myelopathy symptom and radiculopathy symptom (right, symmetric, left). Pre- and postoperative radiographic and clinical parameters and incidence of postoperative C5 palsy were analyzed and compared among the groups. According to dominant compressive side, there were no significant differences in postoperative radiographic and clinical parameters among three groups. According to dominant myelopathy or radiculopathy symptom side, there were no significant differences of all radiographic and clinical parameters postoperatively, except slightly lower neck VAS in groups of preoperative right dominant myelopathy or radiculopathy symptom side at postoperative 1 month. C5 palsies occurred in twelve patients (6.2%), but the incidences were not different among the groups. Therefore, when performing UODL, the choice of lamina opening side can be left to surgeon's preference.
外科医生应选择颈椎单侧开门椎管扩大成形术（UODL）的一侧。然而，很少有报道提出决定打开哪一侧的适当指导方针。本研究旨在评估 UODL 中打开侧对优势脊髓压迫或症状侧的影响。193 例随访时间超过 2 年的退变性颈脊髓神经根病患者被纳入研究。在所有情况下，UODL 均均匀地在右侧进行。根据术前优势 3 个特征，将患者分为亚组：脊髓压迫、脊髓病症状和神经根病症状（右侧、对称、左侧）。分析和比较了各组之间术前和术后的影像学和临床参数以及术后 C5 神经病的发生率。根据优势压迫侧，三组之间术后影像学和临床参数无显著差异。根据术前右侧优势脊髓病或神经根病症状侧的优势脊髓病或神经根病症状侧，除术后 1 个月时颈 VAS 稍低外，所有影像学和临床参数术后均无显著差异。12 例患者（6.2%）发生 C5 神经病，但各组发生率无差异。因此，在进行 UODL 时，椎板开口侧的选择可以由外科医生的偏好决定。
