Clinical Application And Efficacy Of Centerpiece Titanium Plate In Cervical Expansive Open-door Laminoplasty

Objective:to explore the clinical application and efficacy of Centerpiece titanium plate fixation in open door laminoplasty.Methods:34patients received the unilateral open-door cervical expansive laminoplasty fixed by centerpiece plate from March2010to December2012,all patients had decompression rang from C3to C7. There were21males and13females, with a mean age of61.5years(rang,43-75years).The operation time, blood loss and incidence of different symptoms were recorded. Preoperative and postoperative curvature angle was demonstrated by the cross angle between posterior vertebral body margins of C2and C7on cervical radiographs. The sagittal diameter of C5spinal canal on the lateral X-ray was measured before operation and the final follow-up. And the expansion rate of spinal canal was termed[as (postoperative sagittal diameter-preoperative sagittal diameter)/(preoperative sagittal diameter)xl00%]. Degree of spinal cord backwards was recorded from MRI. Clinical outcome was evaluated using Visual Analog Scales(VAS) score and Japanese Orthopaedic Association (JOA) score for all the patients before operation and at1months’,3months’,6months’and12months’follow-up.Results:The average operation time was140±15min,the average intraoperation blood loss was275±25ml. All Patients were followed up for18-28months(mean22.9months). C5palsy was noted in lease3day after operation, which was resolved completely6months after operation.5patients got axial symptoms. Compared to preoperation, the VAS score of1months’,3months’,6months’and12months’follow-up reduced significantly (P <0.05),the JOA score of1months’,3months’,6months’and12months’ follow-up increased significantly(P<0.05), the cervical Cobb angle of1months’,3months’,6months’and12months’follow-up improved significantly (P<0.05).There are not significant differences statistically in comparison between any two groups(P>0.05). The mean sagittal diameter of C5spinal canal was10.4±1.5mm before operation and15.6±1.4mm at final follow-up, with the expansion rate of (68.3±8.9)%. Cervical curvature index was (13.1±1.6)°preoperatively, it was (11.3±1.8)°at final follow-up interval, indicating that cervical curvature index made no progress at final follow-up interval(.P>0.05).Conclusion:Unilateral open-door expansive laminoplasty plus centerpiece titanium plate fixation is reliable, neruo-recoveryd and the early clinical efficacy is satisfactory.