LIYuwei 1 , WANGHaijiao 1 , WANGYisheng 2 , LIUHongjian 2
  • 1. Department of Orthopedics, the First Affiliated Hospital of Luohe Medical College, Luohe Henan, 462000, P. R. China;
  • 2. Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University;
WANGHaijiao, Email: 460910316@qq.com
Cervical spondylotic myelopathy; Cervical stenosis; Posterior cervical laminoplasty
10.7507/1002-1892.20150238
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Objective To observe the effectiveness of posterior cervical laminoplasty, and to determine the significance of the classification of spinal cord compression of multi-level cervical spondylotic myelopathy (CSM). Methods The clinical data were analyzed from 1 216 cases of multi-level CSM undergoing posterior cervical laminoplasty between February 1998 and February 2013. The patients were divided into 4 groups: soft anterior spinal cord compression and light canal occupation (<50%) in 569 cases (46.8%, group A), soft anterior spinal cord compression and heavy canal occupation (≥ 50%) in 365 cases (30.0%, group B), bony anterior spinal cord compression and light canal occupation in 210 cases (17.3%, group C), and bony anterior spinal cord compression and heavy canal occupation in 72 cases (5.9%, group D). There was no significant difference in gender, age, disease duration, lesion level, and complications among 4 groups (P>0.05). Because of different levels of spinal cord compression, there were significant differences in visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score among 4 groups (P<0.05). Results Cerebrospinal fluid leakage occurred in 9 cases (2 cases in group A, 1 case in group B, 3 cases in group C, and 3 cases in group D), and was cured after symptomatical treatment. There was no postoperative complication of wound infection, lamina re-closing, or C5 nerve root paralysis in 4 groups. The follow-up time ranged from 24 to 74 months (mean, 35 months). In group D, 17 patients (23.6%) had deteriorated symptom at 6-12 months after operation, and good recovery was achieved in the patients of the other 3 groups. At last follow-up, the JOA score and VAS score were significantly improved when compared with the preoperative scores in 4 groups (P<0.05); the JOA score, improvement rate, and VAS score of group D were significantly lower than those of groups A, B, and C (P<0.05), but there was no significant difference among groups A, B, and C (P>0.05). Conclusion In the multi-level CSM, the anterior compression of the spinal cord should be classified, this has a guiding significance for the prognosis of CSM and the choice of surgical method.

Citation： LIYuwei, WANGHaijiao, WANGYisheng, LIUHongjian. EFFECT OF ANTERIOR CERVICAL SPINAL CORD COMPRESSION FACTOR IN TREATMENT OF CERVICAL SPONDYLOTIC MYELOPATHY. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(9): 1099-1103. doi: 10.7507/1002-1892.20150238 Copy

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