Abstract
Objective To compare the five-year surgical outcomes between Open-Door laminoplasty (ODL) and French-Door laminoplasty (FDL) in the management of multilevel cervical spondylotic myelopathy (MCSM). Methods Sixty patients with MCSM, who were operated by ODL or FDL, were included in this study and followed up for at least 5 years. The average follow-up period was 69.2 ± 3.2 months. The modified Japanese Orthopaedic Association (mJOA) score and radiological assessments including the Cobb angle and cervical range of motion (ROM) were evaluated and compared before surgery and at the final follow-up. The incidence of postoperative complications and medical costs were also compared. Results Both ODL and FDL groups achieved significant improvements of the mJOA score in postoperative 5 years; the average recovery rate (RR) of the mJOA score in the ODL and FDL groups was 72.14 ± 6.97% and 69.53 ± 7.51%, respectively. No statistically significant differences regarding the pre- and postoperative mJOA score, the RR of the mJOA score, the loss and the loss rate of the Cobb angle, and the incidence of postoperative complications existed between ODL and FDL. The mean loss and the loss rate of cervical ROM in the FDL group (18.70 ± 8.91°, 41.08 ± 11.17%) were significantly higher than those of the ODL group (13.81 ± 8.62°, 31.47 ± 12.43%) (P < 0.05). FDL reduced medical costs more greatly than ODL (33014.37 ± 3424.12 China Yuan versus 82096.62 ± 7093.07 China Yuan, P < 0.001). Conclusions Both ODL and FDL are effective for MCSM. The 5-year neurological results are similar between the two groups. ODL trends to be superior to FDL in postoperative preservation of cervical ROM while FDL reduced medical costs more greatly.
Highlights
OpenDoor Laminoplasty (ODL) trends to be superior to French-Door Laminoplasty (FDL) in postoperative preservation of cervical range of motion (ROM) while FDL reduced medical costs more greatly
For the multilevel cervical spondylotic myelopathy (MCSM), posterior approaches such as laminoplasty and laminectomy have been recognized as effective methods [1, 2]
By comparing the neurological outcomes, radiological outcomes, and incidence of complications after ODL and FDL, we found that both two methods achieved satisfactory surgical outcomes, but ODL achieved better preservation of ROM, while FDL reduced medical costs more greatly
Summary
For the multilevel cervical spondylotic myelopathy (MCSM), posterior approaches such as laminoplasty and laminectomy have been recognized as effective methods [1, 2]. Laminoplasty is put into application as an alternative to laminectomy, which permits adequate decompression while maintaining mechanical stability and motion of the cervical spine [5, 6]. FDL involves opening the “door” in the midline, which creates a symmetrical opening of the canal. Both methods have been reported to show satisfactory short-term clinical outcomes, several complications still existed, such as the loss of cervical range of motion (ROM) and lordosis, postoperative
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
