Application of titanium miniplate to posterior cervical laminoplasty: a short-term follow-up

doi:10.3969/j.issn.2095-4344.2014.35.019

Abstract

Abstract:

BACKGROUND: During cervical posterior expansive open-door laminoplasty for multisegmental cervical spondylosis, spinal canal restenosis, loss of cervical lordosis, and axial symptoms are the important factors affecting curative effects. It is very necessary to maintain spinal canal expanded state and to reduce interference of the posterior cervical structure in the clinical treatment.
OBJECTIVE: To observe clinical outcomes and short-term follow-up effect of posterior expansive open-door laminoplasty via titanium miniplate in treatment of cervical spondylotic myelopathy.
METHODS: A total of 67 patients with cervical spondylotic myelopathy who underwent posterior expansive open-door laminoplasty at the Zhongshan Hospital, Xiamen University from April 2006 to April 2013 were retrospectively analyzed. Titanium miniplate group (n=27) received titanium miniplate fixation. Suture group (n=40) received traditional suture suspension. All patients had decompression ranged from C3-7. Operation time, intraoperative blood loss, improvement rate of Japanese Orthopedic Association score during follow-up, value of cervical curvature, axial symptoms, and lamina opened angle were compared between the two groups.
RESULTS AND CONCLUSION: No significant difference in operation time, intraoperative blood loss and improvement rate of Japanese Orthopedic Association score was detectable between two groups (P > 0.05). Cervical curvature changes in both groups: loss of cervical curvature at 6 months postoperation was not significant in the titanium miniplate group, but cervical curvature partially lost in the suture group, and significant differences in the cervical curvature were detected between the two groups (P < 0.05). The incidence of axial symptoms was significantly lower in the titanium miniplate group than in the suture group at 6 months after surgery (P < 0.05). During final follow-up, no significant difference in the lamina open-angle was detected between titanium miniplate group (35.2±6.2)° and suture group (34.0±4.7)° (P > 0.05). These data suggested that posterior expansive open-door laminoplasty for treatment of cervical spondylotic myelopathy using both titanium miniplate and suture methods can obtain good clinical outcomes. However, titanium miniplate fixation can relieve postoperative axial symptoms and prevent loss of cervical curvature.

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

全文链接：

Key words: cervical vertebrae, internal fixators, follow-up studies

CLC Number:

R318

Xie Bai-zhen, Hua Qiang, Zhao Hui-yi . Application of titanium miniplate to posterior cervical laminoplasty: a short-term follow-up[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(35): 5681-5686.

Figures/Tables 1

2.1 参与者数量分析按意向性处理分析，共纳入67例多节段颈椎病后路椎板成形患者，分为2组：微型钛板组27例，缝线组40例。全部进入结果分析，无脱落。 2.2 基线资料比较两组患者在性别、年龄方面比较差异无显著性意义，具有可比性，见表1。 2.3 随访结果微型钛板组与缝线组手术时间、术中出血量差异均无显著性意义(P > 0.05，表2)。两组患者均未出现严重的术后并发症。两组患者术后均无C5神经根麻痹出现，微型钛板组内固定物位置良好，无松动、拔出和断裂。两组均随访6-24个月，随访时间差异无显著性意义(P > 0.05)。术后6个月测算相关指标，两组患者JOA评分较术前均有不同程度的改善，但两组改善率比较差异无显著性意义(P > 0.05，表3)。轴性症状发生率微型钛板组明显低于缝线组(P < 0.05，表4)。两组患者术前和术后6个月时的颈椎曲度见表5。颈椎曲度变化(C2-7夹角α)：微型钛板组术后与术前比较差异无显著性意义(P > 0.05)，缝线组术后与术前比较差异有显著性意义(P < 0.05)；两组曲度变化值差异有显著性意义(P < 0.05)，微型钛板组术后颈椎曲度丢失不明显，缝线组颈椎曲度部分丢失(P < 0.05)。随访时椎板开门角度微型钛板组(35.2±6.2)°与缝线组(34.0±4.7)°比较，差异无显著性意义(P > 0.05)。 2.4 典型病例男性患者，59岁，诊断脊髓型颈椎病，病变节段C3/4，C4/5，C5/6，C6/7，行后路单开门椎板成形微型钛板置入内固定，固定节段C3，C4，C5，C6。术前JOA评分7分，术后JOA评分13分，随访16个月，无不良事件发生，见图1。 2.5 不良事件微型钛板组和缝线组各有1例出现切口浅表局部感染，经扩创换药待切口好转后重新缝合后愈合。缝线组2例患者出现脑脊液渗漏，经局部压迫及抬高床头后数天自行停止，未影响切口愈合。"

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