Anterior cervical discectomy with fusion and posterior cervical expansive open-door laminoplasty for multilevel cervical spondylotic myelopathy: its postoperative stability

doi:10.3969/j.issn.2095-4344.2017.27.008

Abstract

Abstract:

BACKGROUND: The treatment of multilevel cervical spondylotic myelopathy (MCSM) aims at sustaining the spinal cord compression and restoring the stability of the cervical vertebrae at most.

OBJECTIVE: To analyze the clinical characters of anterior cervical discectomy with fusion and expansive open-door laminoplasty for MCSM.

METHODS: Sixty-seven patients with MCSM were divided into two groups, and treated with anterior cervical discectomy with fusion (group A) or posterior cervical expansive open-door laminoplasty (group B). All the patients were followed up for 12 months, and the range of motion of cervical vertebrae, cervical curvature index were observed, as well as the Visual Analogue Scale and Japanese Orthopaedic Association scores were condueted. Moreover, the operation time, blood loss and adverse reactions were recorded.

RESULTS AND CONCLUSION: (1) The loss of range of motion of the cervical vertebrae in the group B was significantly less than that in the group A (P < 0.05). (2) The cervical curvature index in the group A was significantly improved (P < 0.05), but the index had no significant change in the group B. (3) The axial systems were significantly improved in both groups, especially in the group A (P < 0.05). (4) The neurological function was significantly improved in both groups (P < 0.05), which showed no significant difference between two groups (P > 0.05). (5) The intraoperative blood loss in the group B was significantly more than that in the group A (P < 0.05). (6) The incidence of hoarseness and dysphagia in the group A was 19%. The incidence of wound infection, cerebrospinal fluid leakage and C₅ nerve root palsy in the group B was 9%. (7) These results suggest that during choosing an appropriate method for MCSM, surgeons’ skills and patients’ situation should be considered.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Cervical Vertebrae, Internal Fixators, Postoperative Complications, Tissue Engineering

CLC Number:

R318

Jiang Ze-hua, Zhang Xue-li, Zhu Ru-sen, Ji Ning, Cao Sheng, Lin Yong-zhi, Wan Jun, Liu Yan . Anterior cervical discectomy with fusion and posterior cervical expansive open-door laminoplasty for multilevel cervical spondylotic myelopathy: its postoperative stability [J]. Chinese Journal of Tissue Engineering Research, 2017, 21(27): 4306-4311.

Figures/Tables 3

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