Early clinical efficacy of unilateral open-door cervical expansive laminoplasty plus centerpiece titanium plate fixation for cervical spinal stenosis

English Keywords:Cervical spinal stenosis  Expansive laminoplasty  Unilateral open-door  Centerpiece titanium plate  Internal fixation  Efficacy

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.