Comparison of short term curative effects of open door laminoplasty with different plate density for the treatment of multi segment cervical spondylotic myelopathy

Abstract

To compare the short term curative effect of posterior open door laminoplasty between continuous placement of shaping plate and intermittent placement in treating multilevel cervical spondylotic myelopathy. From January 2012 to March 2015, 43 patients with multi segment cervical spondylotic cervical were treated with posterior open door laminoplasty, 21 patients with continuous placement of shaping plate(continuous group), 22 patients with intermittent placement of shaping plate(intermittent group). Operative time, intraoperative blood loss, JOA score, VAS score, postoperative spinal sagittal diameter and cervical curvature, postoperative cervical activity, complications, hospitalization expenses etc. were observed. The patients of two groups were followed up with an average of (23.2±8.1) months and (23.3±8.0) months in continuous group and intermittent group, respectively. There was no significant difference in operative time, intraoperative blood loss, hospitalization time between two groups(P>0.05). JOA and VAS scores of all patients at final follow up were obviously improved than preoperative(P<0.05). Postoperative spinal sagittal diameter at 3 days and final follow up were obviously improved(P<0.05), and there was no significant difference between postoperative at 3 days and final follow up(P>0.05). Cervical activity of all patients at final follow up was decreased than preoperative(P<0.05), but there was no significant difference between two groups(P>0.05). There was no significant difference in postoperative complication and there was significant difference in hospitalization expenses between two groups. Posterior open door laminoplasty with continuous or intermittent placement of shaping plate have similar clinical effects in ameliorating nerve function for the treatment of multilevel cervical spondylotic myelopahty. However, the hospitalization expenses of intermittent group is obviously reduced, and the medical resources can be saved.