Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan, 430030, People's Republic of China.
Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, 76# Nanguo Road, Xi'an, 710054, People's Republic of China.
Eur Spine J. 2024 Jan;33(1):224-231. doi: 10.1007/s00586-023-07953-5. Epub 2023 Oct 11.
The C3 & C7 dome-hybrid open-door laminoplasty was proven to be an effective treatment for multi-levels cervical spondylotic myelopathy (CSM). However, its superiority over traditional unilateral open-door laminoplasty (UOLP) remains questionable, and no studies have compared the efficacy of this technique with traditional UOLP. This study aimed to compare the effectiveness of C3 & C7 dome-hybrid open-door laminoplasty with traditional UOLP in treating multi-levels CSM.
A retrospective study of multi-levels CSM with laminoplasty was performed, including 35 cases of traditional UOLP and 27 cases of C3 & C7 dome-hybrid open-door laminoplasty. Radiographic evaluation parameters and clinical outcomes were recorded to evaluate the surgical effectiveness.
There was no significant difference in demographic baseline parameters. At the final follow-up, the C2-C7 Cobb angle of the modified group was significantly greater than that of the traditional group (p = 0.026). Meanwhile, the C2-C7 SVA of the modified group was significantly smaller than that of the traditional group (p = 0.009). Clinical outcomes such as VAS, NDI, and SF-12 scores, improved significantly in the modified group compared to the traditional group, while the JOA scores had no significant difference in both groups. There was no significant difference in the overall rate of complications between the two groups.
Both techniques have satisfactory outcomes in treating multi-levels CSM. Comparing with traditional UOLP, C3 & C7 dome-hybrid open-door laminoplasty has a greater superiority in reducing postoperative neck pain and maintaining the cervical sagittal alignment. It is proven to be a feasible management for patients with multi-levels CSM.
C3 和 C7 穹顶-杂交式开门椎管成形术已被证明是治疗多节段颈椎病（CSM）的有效方法。然而，其与传统单侧开门椎管成形术（UOLP）相比的优越性仍存在争议，尚无研究比较该技术与传统 UOLP 的疗效。本研究旨在比较 C3 和 C7 穹顶-杂交式开门椎管成形术与传统 UOLP 治疗多节段 CSM 的效果。
对行椎管成形术的多节段 CSM 进行回顾性研究，包括传统 UOLP 组 35 例和 C3 和 C7 穹顶-杂交式开门椎管成形术组 27 例。记录影像学评估参数和临床结果，以评估手术效果。
两组患者的人口统计学基线参数无显著差异。末次随访时，改良组的 C2-C7 Cobb 角显著大于传统组（p=0.026）。同时，改良组的 C2-C7 SVA 显著小于传统组（p=0.009）。与传统组相比，改良组的 VAS、NDI 和 SF-12 评分等临床结果显著改善，而 JOA 评分两组间无显著差异。两组并发症总发生率无显著差异。
两种技术治疗多节段 CSM 的效果均令人满意。与传统 UOLP 相比，C3 和 C7 穹顶-杂交式开门椎管成形术在减轻术后颈部疼痛和维持颈椎矢状位平衡方面具有更大的优势。对于多节段 CSM 患者，它被证明是一种可行的治疗方法。
