| Objective: To evaluate the early clinical efficacy of posterior cervical open-door laminoplasty with titanium miniplate for multilevel cervical spondylotic myelopathy,for further clinical application and references.Methods:From February 2016 to Sptember 2016,A retrospective analysis on the Department of orthopedics of Shandong Provincial Traditional Chinese Medical Hospital about posterior cervical open-door laminoplasty with titanium miniplate for multilevel cervical spondylotic myelopathy cases,according to the inclusion and exclusion criteria,a total of 19 records of patients,male 13 cases,female 6 cases,aged 33 to 75 years old,average age was 55 years old.In outpatient care,and calls on a regular basis for follow-up after discharge from hospital,followed up for 6 to 13 months,an average of 9 months.Detailed records of 19 cases of patients with preoperative and postoperative 3 months,6 months after operation and last follow-up JOA scores;3 months after surgery,6 months after operation and last follow-up axial symptoms;preoperative and postoperative 3 months and 6 months after surgery of lateral cervical spine X-ray of sagittal diameter of spinal canal,cervical curvature and SVA value;1 week after surgery,6 months after operation of cervical vertebral lamina open angle CT;6 months after surgery,the shaft bone fusion status data,analysis of data using SPSS19.0 statistical software,using P<0.05 as the difference was statistically significant.Results: All 19 patients received complete follow-up,followed up for 6 to 13 months,an average of 9 months.Statistical analysis of data shows: after 3 months,6 months postoperatively,and at the end of the time of follow-up JOA score significantly higher,compared with preoperative JOA and postoperative 3 months and 6 months postoperative JOA score difference had statistical significance(P < 0.05),postoperative 3 months and there was no statistical significance in the last follow-up JOA score difference(P = 0.187 > 0.05);21% incidence of axial symptoms after 3 months,6 months after 15% incidence of axial symptoms,10% incidence of the last follow-up axial symptoms,postoperative axial symptoms gradually improved;Postoperative 3 months and 6 months after vertebral canal sagittal diameter compared with preoperative were significantly expanded,preoperative vertebral canal sagittal diameter was 9.50 ± 0.48 mm,3 months after vertebral canal sagittal diameter was 16.66± 0.55 mm,6 months after vertebral canal sagittal diameter was 16.58 ± 0.50 mm,preoperative and postoperative patients with vertebral canal sagittal diameter 3 months difference had statistical significance(p = 0.003 < 0.05),postoperative 3 months and 6 months after spinal canal vertebral canal sagittal diameter difference has no statistical significance(p = 0.13 > 0.05);Postoperative SVA and cervical curvature is preoperative change is not obvious;Preoperative SVA was 26.21 ±2.49 mm,postoperative 3 months SVA was 26.89 ± 2.26 mm,6 months after SVA was 27.16 ± 2.41 mm,patients with preoperative and postoperative 3 months SVA numerical difference has no statistical significance(p = 0.114 > 0.05),patients with postoperative 3 months and 6 months after SVA numerical difference has no statistical significance(p = 0.556 > 0.05);Preoperative cervical curvature was 15 ± 4.07 °,3 months after cervical curvature was 14.26± 3.46 °,6 months after cervical curvature was 13.84 ± 2.83 °,preoperative and postoperative 3 months cervical curvature difference has no statistical significance(p = 0.167 > 0.05),postoperative 3 months and 6 months after cervical curvature difference reached statistical significance(p = 0.469 > 0.05);Postoperative 1 week and 6 months after vertebral plate open Angle change is not obvious,Postoperative 1 week to open the door Angle was 35.35± 4.26 °,after 6 months open Angle after was 35.92 ± 3.68 °,there was no statistically significant difference(p > 0.05);After 6 months osseous fusion rate was 85%;Postoperative vertebral artery rupture in 1 case,did not see C5 nerve root palsy and then shut down the phenomenon such as other complications.Conclusion: By analyzing the posterior cervical open-door laminoplasty with titanium miniplate for multilevel cervical spondylotic myelopathy early clinical curative effect,We found that this method has the following advantages: 1.This method can effectively enlarge the sagittal diameter of the spinal canal and maintain spinal sagittal diameter and lamina open angle stability,improve neurological symptoms.2.The effect of sagittal balance and cervical physiological curvature was small.3.This method has high bone fusion rate.4.The incidence rate of axial symptoms was low and gradually relieved.The posterior cervical open-door laminoplasty with titanium miniplate for multilevel cervical spondylotic myelopathy is a safe and effective method. |
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