EFFECT OF SPINAL DURAL RELEASE ON TREATMENT OF MULTI-SEGMENTAL CERVICAL MYELOPATHY WITH OSSIFICATION OF POSTERIOR LONGITUDINAL LIGAMENT BY CERVICAL LAMINOPLASTY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIYuwei ,  WANGHaijiao , CUIWei , ZHANGYonghui , SHIJianwei , ZHOUPeng , WENYan

Department of Orthopedics, First Affiliated Hospital of Luohe Medical College, Luohe Henan, 462000, P. R. China;

Corresponding?author：

WANGHaijiao, Email: 460910316@qq.com

Keywords：

Ossification of posterior longitudinal ligament; Multi-segmental cervical myelopathy; Expansive cervical laminoplasty; Spinal dural release

DOI：

10.7507/1002-1892.20160037

Video：

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Objective To explore the effect of spinal dural release on the effectiveness of expansive cervical laminoplasty for treating multi-segmental cervical myelopathy with ossification of posterior longitudinal ligament. Methods A retrospective analysis was made on the clinical data of 32 patients with multi-segmental cervical myelopathy with cervical ossification of posterior longitudinal ligament who underwent expansive cervical laminoplasty and spinal dural release between February 2011 and October 2013 (group A); and 36 patients undergoing simple expansive cervical laminoplasty between January 2010 and January 2011 served as controls (group B). There was no significant difference in gender, age, disease duration, affected segments, combined internal disease, preoperative cervical curvature, Japanese Orthopaedic Association (JOA) score, and visual analogue scale (VAS) score between 2 groups (P>0.05). Postoperative JOA score and improvement rate, VAS score, posterior displacement of the spinal cord, and the change of cervical curvature were compared between 2 groups. Results Spinal dural tear occurred in 3 cases (2 cases in group A and 1 case in group B) during operation. Cerebrospinal fluid leakage occurred in 3 cases (2 cases in group A and 1 case in group B) after operation. The patients were followed up 12-46 months (mean, 18.7 months). At last follow-up, the JOA score and VAS score were significantly improved in 2 groups when compared with preoperative scores (P<0.05). JOA score and improvement rate of group A were significantly higher than those of group B (P<0.05), but VAS score of group A was significantly lower than that of group B (P<0.05). At last follow-up, no significant difference in cervical curvature was found between 2 groups (P>0.05); posterior displacement of the spinal cord of group A was significantly larger than that of group B (P<0.05). No reclosed open-door was observed during follow-up. Conclusion For patients with multi-segmental cervical myelopathy with ossification of posterior longitudinal ligament, full spinal dural release during expansive cervical laminoplasty can increase the posterior displacement of spinal cord, and significantly improve the effectiveness.

Citation： LIYuwei, WANGHaijiao, CUIWei, ZHANGYonghui, SHIJianwei, ZHOUPeng, WENYan. EFFECT OF SPINAL DURAL RELEASE ON TREATMENT OF MULTI-SEGMENTAL CERVICAL MYELOPATHY WITH OSSIFICATION OF POSTERIOR LONGITUDINAL LIGAMENT BY CERVICAL LAMINOPLASTY. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(2): 178-182. doi: 10.7507/1002-1892.20160037 Copy

1.	?連鴻凱, 黃金承, 劉紀恩. 多節段脊髓型頸椎病不同手術方法早期臨床療效探討. 中國修復重建外科雜志, 2014, 28(10):1231-1235.
2.	謝水清, 孫天威, 田融, 等. 脊髓型頸椎病單開門椎板成形術后軸性癥狀的危險因素分析. 中國修復重建外科雜志, 2014, 28(5):620-624.
3.	Kiely PD, Quinn JC, Du JY, et al. Posterior surgical treatment of cervical spondylotic myelopathy:review article. HSS J, 2015, 11(1):36-42.
4.	胡有谷, 陳曉亮, 劉勇, 等. 脊髓型頸椎病與頸椎管狹窄之間的關系及命名探討. 中國脊柱脊髓雜志, 2003, 13(4):203-204.
5.	孟德福, 孫天威, 田融, 等. 頸后路單開門椎管成形術聯合椎間孔切開對預防術后C₅神經根癱的影響. 中國修復重建外科雜志, 2014, 28(4):463-467.
6.	李玉偉, 王海蛟, 嚴曉云, 等. 頸椎單開門椎管擴大成形術不同椎板固定方法治療多節段脊髓型頸椎病的療效分析. 中國脊柱脊髓雜志, 2013, 23(11):973-978.
7.	李玉偉, 王海蛟, 王義生, 等. 不同脊髓前方致壓因素對后路手術治療脊髓型頸椎病療效的影響. 中國修復重建外科雜志, 2015, 29(9):1099-1103.
8.	于斌, 夏英鵬, 杜文軍, 等. 頸椎單開門椎管成形微鈦板與絲線或錨釘固定術后C₅神經根麻痹的對比分析. 中華骨科雜志, 2015, 35(1):11-17.
9.	顧振芳, 申勇, 丁文元, 等. 雙開門椎管擴大椎板成形術中椎管矢狀徑增加值的預測. 中華骨科雜志, 2014, 34(5):510-515.
10.	費琦, 楊雍. 術式改良:重新探討頸椎后路單開門椎管擴大成形術的應用. 中華醫學雜志, 2015, 95(23):1793-1795.
11.	王樂, 劉少喻, 梁春祥, 等. 雙開門椎管擴大成形術治療頸髓揮鞭樣損傷. 中華創傷雜志, 2014, 30(10):1000-1004.
12.	胡孔和, 吳強, 靳安民, 等. 頸椎單開門OsteoMed M3釘板內固定椎管擴大成形術的生物力學研究. 中華實驗外科雜志, 2013, 30(1):129-131.
13.	朱繼超, 劉曉光, 劉忠軍, 等. 術前頸椎曲度與椎管擴大成形術后脊髓后移程度及療效的相關性. 中國脊柱脊髓雜志, 2013, 23(7):587-593.
14.	林建聰, 王少波, 鄭亞才, 等. 單開門頸椎管擴大術后脊髓后移的MRI測量及具臨床意義. 中華外科雜志, 2008, 46(3):224-225.
15.	刁垠澤, 孫宇, 王少波, 等. 頸椎椎板成形術后脊髓后移的相關因素分析. 中華骨科雜志, 2013, 33(5):454-458.
16.	Radcliff KE, Limthongku W, Kepler CK, et al. Cervical laminectomy width and spinal cord drift are risk factors for postoperative C₅ palsy. J Spinal Disord Tech, 2014, 27(2):86-92.
17.	Tashjian VS, Kohan E, McArthur DL, et al. The relationship between preoperative cervical alignment and postoperative spinal cord drift after decompressive laminectomy and arthrodesis for cervical spondylotic myelopathy. Surg Neurol, 2009, 72(2):112-117.
18.	楊海云, 顧銳, 朱本清, 等. 影響單開門椎管擴大成形術治療頸椎病療效的術后相關因素分析. 中華骨科雜志, 2009, 29(9):847-851.
19.	林圣榮, 周非非, 孫宇, 等. 頸后路單開門椎管擴大椎板成形術后頸椎矢狀面平衡的變化. 中華醫學雜志, 2014, 94(35):2726-2730.

1. ?連鴻凱, 黃金承, 劉紀恩. 多節段脊髓型頸椎病不同手術方法早期臨床療效探討. 中國修復重建外科雜志, 2014, 28(10):1231-1235.
2. 謝水清, 孫天威, 田融, 等. 脊髓型頸椎病單開門椎板成形術后軸性癥狀的危險因素分析. 中國修復重建外科雜志, 2014, 28(5):620-624.
3. Kiely PD, Quinn JC, Du JY, et al. Posterior surgical treatment of cervical spondylotic myelopathy:review article. HSS J, 2015, 11(1):36-42.
4. 胡有谷, 陳曉亮, 劉勇, 等. 脊髓型頸椎病與頸椎管狹窄之間的關系及命名探討. 中國脊柱脊髓雜志, 2003, 13(4):203-204.
5. 孟德福, 孫天威, 田融, 等. 頸后路單開門椎管成形術聯合椎間孔切開對預防術后C₅神經根癱的影響. 中國修復重建外科雜志, 2014, 28(4):463-467.
6. 李玉偉, 王海蛟, 嚴曉云, 等. 頸椎單開門椎管擴大成形術不同椎板固定方法治療多節段脊髓型頸椎病的療效分析. 中國脊柱脊髓雜志, 2013, 23(11):973-978.
7. 李玉偉, 王海蛟, 王義生, 等. 不同脊髓前方致壓因素對后路手術治療脊髓型頸椎病療效的影響. 中國修復重建外科雜志, 2015, 29(9):1099-1103.
8. 于斌, 夏英鵬, 杜文軍, 等. 頸椎單開門椎管成形微鈦板與絲線或錨釘固定術后C₅神經根麻痹的對比分析. 中華骨科雜志, 2015, 35(1):11-17.
9. 顧振芳, 申勇, 丁文元, 等. 雙開門椎管擴大椎板成形術中椎管矢狀徑增加值的預測. 中華骨科雜志, 2014, 34(5):510-515.
10. 費琦, 楊雍. 術式改良:重新探討頸椎后路單開門椎管擴大成形術的應用. 中華醫學雜志, 2015, 95(23):1793-1795.
11. 王樂, 劉少喻, 梁春祥, 等. 雙開門椎管擴大成形術治療頸髓揮鞭樣損傷. 中華創傷雜志, 2014, 30(10):1000-1004.
12. 胡孔和, 吳強, 靳安民, 等. 頸椎單開門OsteoMed M3釘板內固定椎管擴大成形術的生物力學研究. 中華實驗外科雜志, 2013, 30(1):129-131.
13. 朱繼超, 劉曉光, 劉忠軍, 等. 術前頸椎曲度與椎管擴大成形術后脊髓后移程度及療效的相關性. 中國脊柱脊髓雜志, 2013, 23(7):587-593.
14. 林建聰, 王少波, 鄭亞才, 等. 單開門頸椎管擴大術后脊髓后移的MRI測量及具臨床意義. 中華外科雜志, 2008, 46(3):224-225.
15. 刁垠澤, 孫宇, 王少波, 等. 頸椎椎板成形術后脊髓后移的相關因素分析. 中華骨科雜志, 2013, 33(5):454-458.
16. Radcliff KE, Limthongku W, Kepler CK, et al. Cervical laminectomy width and spinal cord drift are risk factors for postoperative C₅ palsy. J Spinal Disord Tech, 2014, 27(2):86-92.
17. Tashjian VS, Kohan E, McArthur DL, et al. The relationship between preoperative cervical alignment and postoperative spinal cord drift after decompressive laminectomy and arthrodesis for cervical spondylotic myelopathy. Surg Neurol, 2009, 72(2):112-117.
18. 楊海云, 顧銳, 朱本清, 等. 影響單開門椎管擴大成形術治療頸椎病療效的術后相關因素分析. 中華骨科雜志, 2009, 29(9):847-851.
19. 林圣榮, 周非非, 孫宇, 等. 頸后路單開門椎管擴大椎板成形術后頸椎矢狀面平衡的變化. 中華醫學雜志, 2014, 94(35):2726-2730.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECT OF SPINAL DURAL RELEASE ON TREATMENT OF MULTI-SEGMENTAL CERVICAL MYELOPATHY WITH OSSIFICATION OF POSTERIOR LONGITUDINAL LIGAMENT BY CERVICAL LAMINOPLASTY

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