Department of Spine Surgery, The Third Hospital of Shijiazhuang, No. 15 Tiyu Street, Shijiazhuang, 050000, China.
Department of Endocrinology, Shijiazhuang People's Hospital, Shijiazhuang, 050000, China.
BMC Musculoskelet Disord. 2024 Jul 3;25(1):515. doi: 10.1186/s12891-024-07638-0.
The purpose of this study is to compare radiological and clinical outcomes between alternate levels (C4 and C6) and all levels mini-plate fixation in C3-6 unilateral open-door laminoplasty.
Ninety-six patients who underwent C3-6 unilateral open-door laminoplasty with alternate levels mini-plate fixation (54 patients in group A) or all levels mini-plate fixation (42 patients in group B) between September 2014 and September 2019 were reviewed in this study. Radiologic and clinical outcomes were assessed. Clinical results included Visual Analogue Scale (VAS) of axial neck pain and Japanese Orthopedic Association (JOA) score. Radiographic results included cervical range of motion (ROM), cervical curvature index (CCI), and the spinal canal expansive parameters including open angle, anteroposterior diameter (APD), and Pavlov`s ratio.
There was no significant difference in VAS, JOA score, ROM, and CCI between two groups. There was no significant difference in canal expansion postoperatively between two groups. However, open angle, APD, and Pavlovs ratio in group A decreased significantly during the follow-up. In group B, APD, Pavlovs ratio, and open angle were maintained until the final follow-up. There was no hardware failure or lamina reclosure occurred in both groups during the follow-up. The mean cost of group B was higher than that of group A.
Despite the differences in the maintenance of canal expansion, alternate levels mini-plate fixation can achieve similar clinical outcomes as all levels mini-plate fixation in C3-6 unilateral open-door laminoplasty. As evidenced in this study, we believe C3-6 laminoplasty with alternate levels (C4 and C6) mini-plate fixation is an economical, effective, and safe treatment method.
本研究旨在比较 C3-6 单侧开门椎管扩大成形术中交替水平（C4 和 C6）与全节段微型钢板固定的影像学和临床结果。
回顾 2014 年 9 月至 2019 年 9 月期间采用交替水平微型钢板固定（A 组 54 例）或全节段微型钢板固定（B 组 42 例）行 C3-6 单侧开门椎管扩大成形术的 96 例患者。评估影像学和临床结果。临床结果包括轴向颈痛视觉模拟量表（VAS）和日本骨科协会（JOA）评分。影像学结果包括颈椎活动度（ROM）、颈椎曲度指数（CCI）以及椎管扩张参数，包括开口角、前后径（APD）和 Pavlov 比值。
两组间 VAS、JOA 评分、ROM 和 CCI 无显著差异。两组间术后椎管扩张无显著差异。然而，A 组的开口角、APD 和 Pavlov 比值在随访期间显著下降。B 组的 APD、Pavlov 比值和开口角在最终随访时保持不变。两组在随访过程中均未发生内固定失败或椎板再关闭。B 组的平均费用高于 A 组。
尽管在维持椎管扩张方面存在差异，但 C3-6 单侧开门椎管扩大成形术中交替水平（C4 和 C6）微型钢板固定可获得与全节段微型钢板固定相似的临床结果。本研究表明，我们认为 C3-6 节段的交替水平（C4 和 C6）微型钢板固定是一种经济、有效且安全的治疗方法。
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