Clinical Analysis Of Open-door Laminoplasty By Suture Anchors Versus Simple-Sutures For Treatment Of Multilevel Cervical Spondylotic Myelopathy

Objective: Cervical posterior open-door lanminoplasty(ODL), as the current preferredtreatment for multilevel cervical spondylotic myelopathy(CSM), has proven to gain lots of favorable prognosis. However, the original Hirabayashi technique have also shown many unpleasant complications. This study was designed to assess the clinical efficacy of open-door laminoplasty conducted by suture anchors and simple sutures, and discuss the precaution of complicatios after ODL.Method: 41 cases were analyzed retrospectively. The patients were admitted to Spine Surgery Department at the First Affiliated Hospital of Dalian Medical University between Jan. 2008 and Dec. 2013 to undergo ODL for multilevel CSM. The 41 cases were composed of 22 male and 19 female, with an average age of 61. During surgery, the significant symptomatological side were chosen as the open side, and the other side were chosen as hinge side. The ODL cases were divided into two groups, the suture anchors group and the simple sutures group. All cases were followed up for 12~36 months, including general condition, imaging evaluation, visual analog scale(VAS), Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire(JOACMEQ) et al. All analysis presented in this study were base on following up data acquired at 12 months after ODL.Result: Multilevel CSM can be effectively and safely treated with ODL, the sagittal canal diameter, VAS, JOACMEQ score in simple sutures group were improved from(9.27±1.39)mm,(8.1±1.6) and(9.13±0.57) preoperatively to(15.74±1.41)mm,(2.9±0.7) and(15.19±0.63) postoperatively, respectively; also, the sagittal canal diameter, VAS, JOACMEQ score in suture anchors group were improved from(9.41±1.06)mm,(8.2±0.9) and(8.97±0.69) preoperatively to(15.83±1.12)mm,(1.6±0.6) and(15.60±0.46) postoperatively, respectively. And above all, the sigattal canal diameter of simple sutures group and suture anchors group at 12 months following up were(13.04±1.96)mmand(15.20±1.72)mm respectively, this difference is statistically significant(p<0.05).Conclusion:Cervical posterior open-door lanminoplasty is an effective treatment for multilevel cervical spondylotic myelopathy. The anchor method can effectively prevent spring-back closure, sustain the postoperative stability of neck, reduce complications, and it’s easy operated, affordable, easy to be popularized and applied.