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Effect of decompression range on decompression limit of cervical laminoplasty

Chinese Medical Journal 2020年第8期133卷 909-918页

作者： Yin-Ze Diao Miao Yu Feng-Shan Zhang Yu Sun Shao-Bo Wang Li Zhang Sheng-Fa Pan Zhong-Jun Liu Wei-Shi Li Department of Orthopedics Institute of Spinal SurgeryPeking University Third HospitalBeijing Key Laboratory of Spinal DiseaseBeijing 100191China

Backgrounds:Cervical posterior decompression surgery is used to relieve ventral compression indirectly by incorporating a backward shift of the spinal cord, and this indirect decompression is bound to be limited. This study aimed to determine the decompression limit of posterior surgery and the effect of the decompression ***:We retrospectively reviewed the data of 129 patients who underwent cervical open-door laminoplasty through 2008 to 2012 and were grouped as follows: C4-C7 ( n = 11), C3-C6 ( n = 61), C3-C7 ( n = 32), and C2-C7 ( n = 25). According to the relative location of spinal levels within a decompression range, the type of decompression at a given level was categorized as external decompression (ED;achieved at the levels located immediately external to the decompression range margin), internal decompression (ID;achieved at the levels located immediately internal to the decompression range margin), and central decompression (CD;achieved at the levels located in the center, far from the decompression range margin). The vertebral-cord distance (VCD) was used to evaluate the decompression limit. The C2-C7 angle and VCD on post-operative magnetic resonance images were analyzed and compared between groups. The relationship between VCD and decompression type was analyzed. Moreover, the relationship between the magnitude of the ventral compressive factor and the probability of post-operative residual compression at each level for different decompression ranges was studied. Results:There was no significant kyphosis in cervical curvature (>-5°), and there was no significant difference among the groups ( F = 2.091, P = 0.105). The VCD of a specific level depended on the decompression type of the level and followed this pattern: ED < ID < CD ( P < 0.05). The decompression type of a level was sometimes affected by the decompression range. For a given magnitude of the ventral compressive factor, the probability of residual compression was lower for the group

关键词： Cervical spondylosis ossification of posterior longitudinal ligament Magnetic resonance imaging Laminoplasty

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