标题： Expansive open-door laminoplasty and selective anterior cervical decompression and fusion for treatment of multilevel cervical spondylotic myelopathy.
作者： Liu, Xin-yu; Yuan, Suo-mao; Tian, Yong-hao; Zheng, Yan-ping; Li, Jian-min
作者机构：[ Liu, Xin-yu; Liu XY] Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, China. email@example.com;[ Yuan, Suo-mao; Yuan SM] 更多
来源： Orthopaedic surgery
摘要： OBJECTIVE: To evaluate the clinical results of combined expansive open-door laminoplasty by splitting of spinous processes and selective anterior cervical decompression and fusion in treatment of multilevel severe cervical spondylotic myelopathy (CSM). METHODS: Twenty-eight patients (16 men and 12 women) underwent one-stage combined expansive open-door laminoplasty and selective anterior decompression and fusion for severe CSM; the average patient age was 51.3 years (range, 32-63 years). Clinical results were assessed by Japanese Orthopaedic Association (JOA) scores, number of finger grip and releases (G and R) in ten seconds, hand-grip strength, visual analog scale (VAS) of axial pain, and C2-C7 angle. RESULTS: There was no worsening of neurological symptoms due to cord injury, cerebrospinal fluid leakage, or wound infection. All cases completed one-year follow-up. The JOA scores, number of G and R in ten seconds, and hand-grip strength were all significantly improved (P < 0.05). Satisfactory decompression was shown by MRI or CT to have been achieved in all cases. The C2-C7 angle did not differ significantly from that found pre-operatively. The axial neck pain score was 2.0 +/- 0.1 on VAS. CONCLUSION: Combined expansive open-door laminoplasty by splitting of spinous processes and selective anterior decompression and fusion achieves complete spinal canal decompression with minimal morbidity; this strategy is effective in improving the surgical outcomes of CSM in one-year follow-up.