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| WANG Lei,WANG Wei,ZHANG Yongxing.The mid-long-term influence of open-door laminoplasty with reconstruction of the posterior cervical ligamentous complex on cervical physiological curvature and range of motion[J].Chinese Journal of Spine and Spinal Cord,2014,(3):222-226. |
| The mid-long-term influence of open-door laminoplasty with reconstruction of the posterior cervical ligamentous complex on cervical physiological curvature and range of motion |
| Received:January 12, 2013 Revised:February 21, 2014 |
| English Keywords:Cervical vertebrae Ligament complex Insertion of extensor Open-door Laminoplasty Alignment Range of motion |
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| 【Abstract】 Objectives: To study the mid-long-term influence of open-door laminoplasty with reconstruction of the posterior cervical ligamentous complex on cervical physiological curvature and range of motion． Methods: From January 2005 to January 2008, 20 patients undergoing open-door laminoplasty with reconstruction of the posterior cervical ligamentous complex were reviewed retrospectively, the series consisted of 12 males and 8 females, aged 37-68 years(average, 52 years)． The JOA score, alignment of the cervical spine and the ROM of the cervical spine were analyzed before and after operation respectively． Results: 20 patients were followed-up for a mean time of 7 years(range, 5-8 years). The mean JOA score was 9.5(7-13) before operation. At final follow up, the mean JOA score was 14.0(9-17) and the recovery rate was 52%, which showed significant improvement(P<0.05), compared with the preoperative ones. The mean C5 vertebral canal/body ratio of X-ray measurements with the neutral position was 0.67(0.56-0.8) before operation. Postoperative sagittal diameter of canal expanded significantly, at neutral position at final follow-up was 1.21(0.86-1.42)(P<0.05). The mean C2-C7 Cobb angle at neutral position at final follow-up was 8.6(4-16), which showed significant difference(P<0.05) compared with the preoperative(0-16°, mean 7.8°); 26 degrees(21-29 degrees) for extension, no significant difference(P＞0.05) compared with the preoperative(29°); and 7 degrees(5.5-19 degrees) for flexion, which showed significant difference(P<0.05) compared with the preoperative(-15°). The mean ROM was 42.1° before operation, and it was 28° after operation. The postoperative extension position averaged 26°(21°-29°), no significant difference compared with the preoperative(28°, P＞0.05), and flexion position averaged 7°(5.5°-19°), showing significant difference compared with the preoperative(16°, P＜0.05). Replanted spinous process and the float laminae got bony fusion. No door re-closure was observed, and good vertebral canal maintaining was maintained. Conclusions: After open-door laminoplasty, the procedure of reconstruction of the posterior cervical ligamentous complex and the insertion of extensor to treat CSM will be helpful on maintaining the cervical physiological curvature, but it reduces the range of motion through the mid-long-term observation. |
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