Clinical outcomes of modified versus traditional expansive open-door laminoplasty for cervical spondylotic myelopathy: A single-institution experience.

IF 1.6 4区医学 Journal of Orthopaedic Surgery Pub Date : 2023-09-01 DOI:10.1177/10225536231209556

Zhitao Shangguan, Gang Chen, Wenge Liu, Jiandong Li

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Abstract

Purpose: To compare the surgical outcomes of modified expansive open-door laminoplasty (EOL) (C4-C6) and traditional EOL (C3-C7) in patients with cervical spondylotic myelopathy (CSM).

Methods: One hundred and two CSM patients were retrospectively recruited from Fujian Medical University Union Hospital between March 2012 and December 2019. Seventy-one patients with CSM underwent modified EOL, and 31 patients underwent traditional EOL. The primary endpoint was axial symptoms.

Results: Patients who underwent modified EOL had a significantly lower incidence of axial symptoms (odds ratio: 0.273; 95% confidence interval: 0.184-0.691; p = .002). The length of hospital stay (p = .263), and intraoperative blood loss (p = .402) were not significantly different between the groups. Significantly more postoperative drainage was observed in patients who underwent modified EOL (p < .001), while the cost of hospitalization in patients treated with traditional EOL was higher (p = .011). There were significant differences between modified and traditional EOL for the changes in range of motion (p < .001), modified Japanese Orthopaedic Association score (p = .001), and the Nurick grade (p = .014), while the changes of visual analogue scale (p = .250), and the neck disability index (p = .134) were not significantly different between the groups.

Conclusion: This study found modified EOL may decrease the incidence of axial symptoms in patients with CSM compared to traditional EOL.

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改良与传统开放式椎板成形术治疗脊髓型颈椎病的临床结果:一项单一机构的经验。

目的:比较改良开放式椎板成形术(EOL) (C4-C6)与传统EOL (C3-C7)治疗脊髓型颈椎病(CSM)的手术效果。方法:回顾性收集2012年3月至2019年12月福建医科大学协和医院收治的脊髓型颈椎病患者102例。71例CSM患者行改良EOL, 31例行传统EOL。主要终点为轴向症状。结果:行改良EOL的患者轴向症状发生率显著降低(优势比:0.273;95%置信区间:0.184-0.691;P = .002)。两组住院时间(p = 0.263)和术中出血量(p = 0.402)差异无统计学意义。改良EOL的患者术后引流明显增加(p < 0.001)，而传统EOL的患者住院费用较高(p = 0.011)。改良EOL与传统EOL在活动范围变化(p < 0.001)、改良日本骨科协会评分(p = 0.001)和Nurick评分(p = 0.014)方面差异有统计学意义，而视觉模拟评分(p = 0.250)和颈部残疾指数(p = 0.134)的变化组间差异无统计学意义。结论:本研究发现改良的EOL与传统的EOL相比，可减少CSM患者轴向症状的发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Journal of Orthopaedic Surgery Medicine-Surgery

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期刊介绍： Journal of Orthopaedic Surgery is an open access peer-reviewed journal publishing original reviews and research articles on all aspects of orthopaedic surgery. It is the official journal of the Asia Pacific Orthopaedic Association. The journal welcomes and will publish materials of a diverse nature, from basic science research to clinical trials and surgical techniques. The journal encourages contributions from all parts of the world, but special emphasis is given to research of particular relevance to the Asia Pacific region.