Modified open-door laminoplasty with preserved posterior cervical musculo-ligamentous complex in the treatment of cervical spondylotic myelopathy: neurological function and axial symptoms

doi:10.12307/2021.325

Abstract

Abstract: BACKGROUND: Cervical spondylotic myelopathy causes spinal canal stenosis and spinal cord dysfunction through direct or indirect compression of the spinal cord or surrounding blood vessels. Posterior cervical laminoplasty for cervical spondylotic myelopathy is effective and widely used in clinical practice.
OBJECTIVE: To evaluate the repair effect of modified open-door laminoplasty with preserved posterior cervical musculo-ligamentous complex in the treatment of cervical spondylotic myelopathy.
METHODS: Medical record data of 126 patients with cervical spondylotic myelopathy from Tianyou Hospital Affiliated to Wuhan University of Science & Technology from June 2015 to July 2018 were retrospectively analyzed. They were assigned to two groups according to the surgical program. The 72 patients in the modified group received modified open-door laminoplasty with preserved posterior cervical musculo-ligamentous complex. The 54 patients in the control group received traditional vertebral plate keratoplasty. Baseline data, operation time, intraoperative blood loss, cervical curvature index, range of motion, and posterior cervical volume were compared between the two groups. Japanese Orthopaedic Association Scores, visual analogue scale scores, and Neck disability index were recorded before surgery, 24 months after surgery, and during final follow-up. The incidence of complications was recorded after surgery.
RESULTS AND CONCLUSION: (1) The last follow-up showed that the cervical curvature rate, range of motion, and cervical curvature index in the modified group were better than those in the control group (P < 0.01). (2) Compared with the control group, visual analogue scale score and Neck disability index were significantly lower in the modified group (P < 0.01). (3) The body volume on the hinge side in the modified group was not significantly different from that before surgery, but it was significantly increased compared with the control group (P < 0.01). (4) In addition, the incidence of axial symptoms in the modified group was significantly lower than that in the control group (6% vs. 22%), and the difference was statistically significant (P < 0.05). (5) It is suggested that modified open-door laminoplasty with posterior cervical musculo-ligamentous complex is an effective method for the treatment of cervical spondylotic myelopathy. The patient’s neurological function recovered well, and the curvature and range of motion of cervical vertebra were well maintained. Moreover, it reduced the incidence of postoperative axial symptoms compared to traditional open-door laminoplasty.

Key words: cervical spondylotic myelopathy, open-door laminoplasty, axial symptoms, posterior cervical muscle ligamentous complex, cervical curvature

CLC Number:

Zhao Lingtong, Hu Bing. Modified open-door laminoplasty with preserved posterior cervical musculo-ligamentous complex in the treatment of cervical spondylotic myelopathy: neurological function and axial symptoms[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(33): 5345-5350.

Figures/Tables 8

References

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