Influence of hinge position on the effectiveness of open-door expansive laminoplasty for cervical spondylotic myelopathy
Influence of hinge position on the effectiveness of open-door expansive laminoplasty for cervical spondylotic myelopathy作者机构：Department of Orthopaedic Surgery Tianjin Union Medicine Center Tianjin China
出 版 物：《Chinese Journal of Traumatology》 (中华创伤杂志（英文版）)
年 卷 期：2011年第14卷第1期
页 面：36-41页
学科分类：090603[农学-临床兽医学] 0402[教育学-心理学(可授教育学、理学学位）] 040203[教育学-应用心理学] 04[教育学] 09[农学] 0906[农学-兽医学]
主 题：Cervical vertebrae Spinal cord diseases Spondylosis Surgical procedures,operative
摘 要：Objective： To assess the influence of different hinge positions on clinical results of expansive open-door laminoplasty （EOLP） for cervical spondylotic myelopathy （CSM）.Methods： A total of 102 CSM patients who underwent EOLP from February 2006 to February 2007 were enrolled in this randomized controlled trial. Using a random digits table,57 patients with the hinge located at the inner margin of the lateral mass were classified as wide-open group, while 45 patients with the hinge positioned at the lamina margin served as narrow-open group. All patients were observed over 24 months, and the clinical and radiological results were analyzed ***： There were no significant differences in operation duration, intraoperative bleeding volume, Japanese Orthopaedic Association （JOA） scores, cervical curvature index, range of motion and neural function recovery *** neural functions were satisfactorily improved after surgery in both groups, while the severity of axial symptoms was significantly lower in the narrow-open group than in the wide-open group （P=0.003）. The incidence of C5 palsy in the wide-open group was higher than that in the narrowopen group （5.3% vs 0）, even though the difference did not reach statistical significance （one tailed Fisher＇s exact test,P=0.17）.Conclusions： Proper inward shift of the hinge can ensure effectiveness of surgical decompression, avoid an excessive backward shift of the spinal cord, decrease the incidence of C5 palsy and alleviate the severity of axial symptoms.
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