WANG Lei,LI Tao,SONG Yueming.Early clinical efficacy of unilateral open-door cervical expansive laminoplasty plus centerpiece titanium plate fixation for cervical spinal stenosis[J].Chinese Journal of Spine and Spinal Cord,2011,(8):654-658.
Early clinical efficacy of unilateral open-door cervical expansive laminoplasty plus centerpiece titanium plate fixation for cervical spinal stenosis
Received:April 13, 2011  Revised:May 28, 2011
English Keywords:Cervical spinal stenosis  Expansive laminoplasty  Unilateral open-door  Centerpiece titanium plate  Internal fixation  Efficacy
Fund:
Author NameAffiliation
WANG Lei Department of Orthopedicsthe West China Hospital of Sichuan UniversityChengdu 610041China 
LI Tao 四川大学华西医院骨科 610041 四川省成都市 
SONG Yueming 四川大学华西医院骨科 610041 四川省成都市 
刘 浩  
裴福兴  
刘立岷  
龚 全  
孔清泉  
曾建成  
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English Abstract:
  【Abstract】 Objective:To evaluate the early clinical efficacy of unilateral open-door cervical expansive laminoplasty plus centerpiece titanium plate fixation for cervical spinal stenosis.Method:From August 2009 to June 2010,30 cases suffering from cervical spinal stenosis underwent unilateral open-door expansive laminoplasty plus centerpiece fixation,of these,there were 23 males and 7 females,with a mean age of 65.2 years(range, 42-81 years).Preoperative MRI showed stenosis at three levels in 9 cases,four levels in 15 and five levels in 6.The neurofunction was evaluated by Japan Orthopaedic Association(JOA) score;X-ray,CT and MRI were used to evaluate postoperative spinal canal enlargement and bone fusion at the hinge side.The sagittal diameter of C5 spinal canal on the lateral X-ray was measured before operation and 3 days,6 months after operation respectively,and the expansion rate of spinal canal was termed [as(postoperative sagittal diameter-preoperative sagittal diameter)/(preoperative sagittal diameter)×100%].Result:The average operation time was 145±20min;the average intraoperative blood loss was 215±75ml;no complications was noted during operation.C5 palsy was noted in 1 case 1 day after operation,which was relieved significantly after 2 weeks of correspondent intervention and resolved completely 2 months after operation.All patients were followed up for 9-20 months(mean 14.6 months). The average JOA score for preoperation was 8.7±0.8 and 15.2±1.1 at 6 months after operation,with the improvement rate of (75±8)%.Radiographic findings showed spinal canal enlarged perfectly at 3 days and 6 months after operation.The mean sagittal diameter of C5 spinal canal was 9.2±0.8mm before operation and 15.9±1.2mm at 3 days and 6 months after operation,with the expansion rate of (71.8±11.0)%.CT scan showed bony fusion at hinge side at 6 months after operation without recurrence of cervical stenosis and neurofunction deterioration.Conclusion:Unilateral open-door expansive laminoplasty plus centerpiece titanium plate fixation is simple and reliable,and the early clinical efficacy is satisfactory.
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