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.	连鸿凯, 黄金承, 刘纪恩. 多节段脊髓型颈椎病不同手术方法早期临床疗效探讨. 中国修复重建外科杂志, 2014, 28(10):1231-1235.
2.	谢水清, 孙天威, 田融, 等. 脊髓型颈椎病单开门椎板成形术后轴性症状的危险因素分析. 中国修复重建外科杂志, 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, 陈晓亮, 刘勇, 等. 脊髓型颈椎病与颈椎管狭窄之间的关系及命名探讨. 中国脊柱脊髓杂志, 2003, 13(4):203-204.
5.	孟德福, 孙天威, 田融, 等. 颈后路单开门椎管成形术联合椎间孔切开对预防术后C₅神经根瘫的影响. 中国修复重建外科杂志, 2014, 28(4):463-467.
6.	李玉伟, 王海蛟, 严晓云, 等. 颈椎单开门椎管扩大成形术不同椎板固定方法治疗多节段脊髓型颈椎病的疗效分析. 中国脊柱脊髓杂志, 2013, 23(11):973-978.
7.	李玉伟, 王海蛟, 王义生, 等. 不同脊髓前方致压因素对后路手术治疗脊髓型颈椎病疗效的影响. 中国修复重建外科杂志, 2015, 29(9):1099-1103.
8.	于斌, 夏英鹏, 杜文军, 等. 颈椎单开门椎管成形微钛板与丝线或锚钉固定术后C₅神经根麻痹的对比分析. 中华骨科杂志, 2015, 35(1):11-17.
9.	顾振芳, 申勇, 丁文元, 等. 双开门椎管扩大椎板成形术中椎管矢状径增加值的预测. 中华骨科杂志, 2014, 34(5):510-515.
10.	费琦, 杨雍. 术式改良:重新探讨颈椎后路单开门椎管扩大成形术的应用. 中华医学杂志, 2015, 95(23):1793-1795.
11.	王乐, 刘少喻, 梁春祥, 等. 双开门椎管扩大成形术治疗颈髓挥鞭样损伤. 中华创伤杂志, 2014, 30(10):1000-1004.
12.	胡孔和, 吴强, 靳安民, 等. 颈椎单开门OsteoMed M3钉板内固定椎管扩大成形术的生物力学研究. 中华实验外科杂志, 2013, 30(1):129-131.
13.	朱继超, 刘晓光, 刘忠军, 等. 术前颈椎曲度与椎管扩大成形术后脊髓后移程度及疗效的相关性. 中国脊柱脊髓杂志, 2013, 23(7):587-593.
14.	林建聪, 王少波, 郑亚才, 等. 单开门颈椎管扩大术后脊髓后移的MRI测量及具临床意义. 中华外科杂志, 2008, 46(3):224-225.
15.	刁垠泽, 孙宇, 王少波, 等. 颈椎椎板成形术后脊髓后移的相关因素分析. 中华骨科杂志, 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.	杨海云, 顾锐, 朱本清, 等. 影响单开门椎管扩大成形术治疗颈椎病疗效的术后相关因素分析. 中华骨科杂志, 2009, 29(9):847-851.
19.	林圣荣, 周非非, 孙宇, 等. 颈后路单开门椎管扩大椎板成形术后颈椎矢状面平衡的变化. 中华医学杂志, 2014, 94(35):2726-2730.

1. 连鸿凯, 黄金承, 刘纪恩. 多节段脊髓型颈椎病不同手术方法早期临床疗效探讨. 中国修复重建外科杂志, 2014, 28(10):1231-1235.
2. 谢水清, 孙天威, 田融, 等. 脊髓型颈椎病单开门椎板成形术后轴性症状的危险因素分析. 中国修复重建外科杂志, 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, 陈晓亮, 刘勇, 等. 脊髓型颈椎病与颈椎管狭窄之间的关系及命名探讨. 中国脊柱脊髓杂志, 2003, 13(4):203-204.
5. 孟德福, 孙天威, 田融, 等. 颈后路单开门椎管成形术联合椎间孔切开对预防术后C₅神经根瘫的影响. 中国修复重建外科杂志, 2014, 28(4):463-467.
6. 李玉伟, 王海蛟, 严晓云, 等. 颈椎单开门椎管扩大成形术不同椎板固定方法治疗多节段脊髓型颈椎病的疗效分析. 中国脊柱脊髓杂志, 2013, 23(11):973-978.
7. 李玉伟, 王海蛟, 王义生, 等. 不同脊髓前方致压因素对后路手术治疗脊髓型颈椎病疗效的影响. 中国修复重建外科杂志, 2015, 29(9):1099-1103.
8. 于斌, 夏英鹏, 杜文军, 等. 颈椎单开门椎管成形微钛板与丝线或锚钉固定术后C₅神经根麻痹的对比分析. 中华骨科杂志, 2015, 35(1):11-17.
9. 顾振芳, 申勇, 丁文元, 等. 双开门椎管扩大椎板成形术中椎管矢状径增加值的预测. 中华骨科杂志, 2014, 34(5):510-515.
10. 费琦, 杨雍. 术式改良:重新探讨颈椎后路单开门椎管扩大成形术的应用. 中华医学杂志, 2015, 95(23):1793-1795.
11. 王乐, 刘少喻, 梁春祥, 等. 双开门椎管扩大成形术治疗颈髓挥鞭样损伤. 中华创伤杂志, 2014, 30(10):1000-1004.
12. 胡孔和, 吴强, 靳安民, 等. 颈椎单开门OsteoMed M3钉板内固定椎管扩大成形术的生物力学研究. 中华实验外科杂志, 2013, 30(1):129-131.
13. 朱继超, 刘晓光, 刘忠军, 等. 术前颈椎曲度与椎管扩大成形术后脊髓后移程度及疗效的相关性. 中国脊柱脊髓杂志, 2013, 23(7):587-593.
14. 林建聪, 王少波, 郑亚才, 等. 单开门颈椎管扩大术后脊髓后移的MRI测量及具临床意义. 中华外科杂志, 2008, 46(3):224-225.
15. 刁垠泽, 孙宇, 王少波, 等. 颈椎椎板成形术后脊髓后移的相关因素分析. 中华骨科杂志, 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. 杨海云, 顾锐, 朱本清, 等. 影响单开门椎管扩大成形术治疗颈椎病疗效的术后相关因素分析. 中华骨科杂志, 2009, 29(9):847-851.
19. 林圣荣, 周非非, 孙宇, 等. 颈后路单开门椎管扩大椎板成形术后颈椎矢状面平衡的变化. 中华医学杂志, 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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