Clinical Study of Cervical Spondylotic Myelopathy Treated by Single Door Laminoplasty

Tao CHEN; Tingrui WANG; Huanxiong CHEN; Kaizhong ZHU; Zhenhao ZHONG; Zhibin MENG

doi:10.12259/j.issn.2095-610X.S20230602

Volume 44 Issue 6

Jun. 2023

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Article Navigation > Journal of Kunming Medical University > 2023 > 44(6): 47-53

Tao CHEN, Tingrui WANG, Huanxiong CHEN, Kaizhong ZHU, Zhenhao ZHONG, Zhibin MENG. Clinical Study of Cervical Spondylotic Myelopathy Treated by Single Door Laminoplasty[J]. Journal of Kunming Medical University, 2023, 44(6): 47-53. doi: 10.12259/j.issn.2095-610X.S20230602

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Tao CHEN, Tingrui WANG, Huanxiong CHEN, Kaizhong ZHU, Zhenhao ZHONG, Zhibin MENG. Clinical Study of Cervical Spondylotic Myelopathy Treated by Single Door Laminoplasty[J]. Journal of Kunming Medical University, 2023, 44(6): 47-53. doi: 10.12259/j.issn.2095-610X.S20230602

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Clinical Study of Cervical Spondylotic Myelopathy Treated by Single Door Laminoplasty

doi: 10.12259/j.issn.2095-610X.S20230602

Dept. of Spinal Surgery，First Affiliated Hospital of Hainan Medical College，Haikou Hainan 570102，China

Received Date: 2023-03-07
Available Online: 2023-06-17
Publish Date: 2023-06-25

Abstract

Abstract

Objective By analyzing the long term clinical effect of patients after single open-door cervical laminoplasty, the correlation between the change of cervical spinal cord area and the long term clinical effect of patients was discussed. Methods A retrospective analysis was performed on 60 patients with cervical spondylotic myelopathy who underwent cervical single open-door laminoplasty in the First Affiliated Hospital of Hainan Medical College from November 2015 to June 2021. The long-term clinical efficacy was evaluated by Japanese Orthopaedic Association （JOA ） improvement rate at the last follow-up. 32 patients with JOA improvement rate of > 60% at the last follow-up were divided into good prognosis group, while 28 patients with JOA improvement rate of ≤60% at the last follow-up were divided into poor prognosis group. Gender, age, duration of symptoms, blood loss, operation time, preoperative and postoperative JOA score were observed. Spinal canal sagittal diameter, cervical curvature index, cervical range of motion, spinal canal area and cervical spinal cord area were measured by preoperative and postoperative cervical MRI, CT and X-ray. Results The change of cervical spinal cord area in the good prognosis group was （55 ± 41 ） mm², which was significantly larger than that in the poor prognosis group （35 ± 37 ） mm², and the difference between the two groups was statistically significant （P < 0.05 ）. The preoperative and postoperative spinal canal area and the axial position in the good prognosis group were significantly larger than those in the poor prognosis group （P < 0.05 ）. But there was no significant difference in the preoperative and postoperative spinal canal ulnar diameter and cervical activity between the two groups （P > 0.05 ）. Multivariate regression analysis showed that preoperative （OR = 6.924, P < 0.05） and postoperative JOA score （OR = 22.000, P < 0.05 ）, preoperative spinal canal area （OR = 2.518, P < 0.05 ） and cervical spinal cord area change （OR = 5.513, P < 0.05 ） were related to the improvement rate of JOA at the last follow-up. Conclusion The change of cervical spinal cord area after SDCL, preoperative cervical spinal canal area, and preoperative and postoperative JOA score are closely related to the improvement rate of JOA at the last follow-up. Surgeons can predict the long-term efficacy of the patients according to the change of cervical spinal cord area after SDCL.
- Cervical single open-door laminoplasty,
- Cervical vertebra,
- Area of cervical spinal cord,
- JOA score,
- Spinal canal area

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References(29)

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