An Applied Anatomy Research of Digital-CT-based Unilateral Open-door Cervical Expansive Laminoplasty of C<sub>7</sub>_Chinese Journal of Evidence-Based Medicine

Authors：

 QILin ,  LIUHao , CHENHua , RONGXin , WUWen-jie , GONGQuan , SONGYue-ming

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LIUHao, Email: liuhao6304@126.com

Keywords：

Open-door cervical expansive laminoplasty; Centerpiece; Applied anatomy; Open-door side; Sloting side

DOI：

10.7507/1672-2531.20150168

Video：

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Objective To explore early clinical effects of Centerpiece-based unilateral open-door cervical expansive laminoplasty plus centerpiece titanium minitype plate fixation, to research the data of the best slotting in the CT-based open-door cervical operation and to provide the reference for accurate operation. Methods A retrospective analysis of the patients who had received Centerpiece-based unilateral open-door cervical expansive laminoplasty plus centerpiece titanium plate fixation from West China Hospital of Sichuan University from February 2013 to November 2013 were performed. The neurological function assessment results (JOA score), cervical curvature indexhave, Pavlov value, spinal canal cross-sectional area and different position, angle and depth of C₇ lamina slotting data of all patients before and after the operation were all analyzed and compared. Results A total of 58 patients were included. The postoperative JOA score was significantly higher than that of the preoperative (9.4±2.9 vs. 14.7±2.6, t=11.417, P=0.000). The sagittal diameter of vertebral canal (21.3±2.1 mm vs. 9.7±2.1 mm, t=27.737, P=0.000), Pavlov value (0.92±0.13 vs. 0.44±0.12, t=30.621, P=0.000), and spinal canal cross-sectional area (276±37 mm² vs. 129±25 mm², t=32.104, P=0.000) at the end of the last follow-up were significantly greater than those of preoperative. When comparing the last follow-up with preoperative, cervical curvature index showed significant difference (11.2±11.5 vs. 9.3±11.7, t=-1.713, P=0.000). Significant differences were found in the comparison of the ideal position and angle of the open door of the C₇ lamina and the angle and position of the operation (all P values >0.05); when comparing the position and angle of the ideal position and angle of the C₇ lamina hinge with that of the actual operation, no significant differences were found (all P values >0.05); but when comparing the ideal depth with the actual depth of the operation, a significant difference was found (P<0.05). Conclusion Centerpiece micro plate used in posterior cervical expansive open-door laminoplasty forming operation of laminectomy fixed screw loosening and plate breakage, can effectively maintain the lamina in the open state, and prevent it to be closed. The patients have good recovery of nerve function after operation and the clinical efficacy is good.

Citation： QILin, LIUHao, CHENHua, RONGXin, WUWen-jie, GONGQuan, SONGYue-ming. An Applied Anatomy Research of Digital-CT-based Unilateral Open-door Cervical Expansive Laminoplasty of C₇. Chinese Journal of Evidence-Based Medicine, 2015, 15(9): 1005-1009. doi: 10.7507/1672-2531.20150168 Copy

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1. Rhee JM, Basra S. Posterior surgery for cervical myelopathy:laminectomy, laminectomy with fusion, and laminoplasty. Asian Spine J, 2008, 2(2):114-126.
2. Komagata M, Inahata Y, Nishiyama M, et al. Treatment of myelopathy due to cervicothoracic OPLL via open doorlaminoplasty. J Spinal Disord Tech, 2007, 20(5):342-346.
3. Itoh T, Tsuji H. Technical improvements and results of laminoplasty for compressive myelopathy in the cervical spine. Spine (Phila Pa 1976), 1985, 10(8):729-736.
4. Lee DH, Hwang CJ, Lee CS, et al. Hinge reclosure phenomenon after classic Hirabayashi open-door laminoplasty. Spine J, 2010, 10(9):S81-82.
5. Liu G, Buchowski JM, Bummabrusert T, et al. Revision surgery following cervical laminoplasty:etiology and treatment strategies. Spine(Phila pa 1976), 2009, 34(25):2760-2768.
6. 陈华, 刘浩, 邹黎, 等. 颈椎单开门椎管扩大成形术铰链侧不同程度骨折后骨愈合的对比研究. 中华骨科杂志, 2013, 33(6):2253-2352.
7. Japanese Orthopaedic Association:Criteria on the evaluation of the treatment of cervical myelopathy. Nippon Seikeigeka Gakkai Zasshi, 50:Addenda 5.
8. 夏英鹏, 张学利, 李辉南. 门轴位置对单开门颈椎管成形术效果的影响. 中华外科杂志, 2010, 48(16):1229-1233.
9. Wang JM, Roh KJ, Kim DJ, et al. A new method of stabilizing the elevated laminae in open-door laminoplasty using an anchor system. J Bone Joint Surg(Br), 1998, 80(6):1005-1008.
10. Yang SC, Niu CC, Chen WJ, et al. Open-door laminoplasty for multilevel cervical spondylotic myelopathy:good outcome in 12 patients using suture anchor fixation. Acta Orthopaedica, 2008, 79(1):62-66.
11. Deutsch H, Mummaneni PV, Rodts GE, et al. Posterior cervical laminoplasty using a new plating system:technical note. J Spinal Disord Tech, 2004, 17(4):317-320.
12. Dimar JR,Bratcher KR,Brock DC, et al. Instrumented opendoorlaminoplasty as treatment for cervical myelopathy in 104 patients. Am J Ortho, 2009, 38(7):E123-128.
13. 王成旭, 李岩, 马威, 等. 中国地区成人C₃~L5椎孔形态的测量及临床应用研究. 中国临床解剖杂志, 2009, 27(1):45-48.

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An Applied Anatomy Research of Digital-CT-based Unilateral Open-door Cervical Expansive Laminoplasty of C₇

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An Applied Anatomy Research of Digital-CT-based Unilateral Open-door Cervical Expansive Laminoplasty of C₇