Open-Door Cervical Laminoplasty with Preservation of Posterior Structures

被引:21
作者
Abdullah, Kalil G. [1 ,2 ,3 ]
Yamashita, Takayuki [4 ]
Steinmetz, Michael P. [6 ,7 ]
Lubelski, Daniel [1 ,2 ,3 ]
Wang, Jeffrey C. [5 ]
Benzel, Edward C. [1 ,2 ,3 ]
Mroz, Thomas E. [1 ,2 ,3 ,4 ]
机构
[1] Cleveland Clin Lerner Coll Med, Cleveland, OH USA
[2] Cleveland Clin, Cleveland Clin Ctr Spine Hlth, Cleveland, OH USA
[3] Cleveland Clin, Dept Neurol Surg, Cleveland, OH USA
[4] Cleveland Clin, Dept Orthopaed Surg, Cleveland, OH USA
[5] Univ Calif Los Angeles, UCLA Comprehens Spine Ctr, Los Angeles, CA USA
[6] MetroHlth Med Ctr, Cleveland, OH USA
[7] Case Western Reserve Univ Sch Med, Cleveland, OH USA
关键词
laminoplasty; open-door laminoplasty; cervical spondylotic myelopathy; range of motion; alignment;
D O I
10.1055/s-0032-1307258
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective To demonstrate that preservation of all posterior structures during open-door laminoplasty (ODL) is associated with a significant preservation of motion. Methods Fifteen patients underwent cervical ODL by one surgeon for treatment of cervical spondylotic myelopathy. An open-door technique was employed, and the laminae on the open side were reconstructed using miniplates with allograft strut bone graft. All spinous processes and interspinous and supraspinous ligaments were preserved within the operative levels and between supra- and subjacent levels in all patients. Postoperative radiographs were obtained 1.5, 3, 6, and 12 months. Computed tomography scans were obtained at 12 months. Results There were no significant intraoperative or perioperative complications. Postoperatively, the neutral angle was 6.8 +/- 11.5 degrees (95% confidence interval: 0.5 to 13.1), representing a loss of of 3 degrees (not significant). The difference between the preoperative and postoperative arc range of motion was 5.96 +/- 11.9 degrees (confidence interval: -0.62 to 12.5). The average percent loss of motion was 3.5% +/- (0.1 to 6.9%). Four patients had an increased range of motion postoperatively. Conclusion Open-door laminoplasty with preservation of all posterior structures provides greater preservation of motion than has been previously described.
引用
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页码:15 / 20
页数:6
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