Double-door laminoplasty combined with C2 dome decompression for the treatment of cervical spinal stenosis

Abstract

To investigate the clinical effect of double-door laminoplasty combined with C2 dome decompression in treatment of cervical spinal stenosis. The clinical data of 28 patients with cervical spinal stenosis who underwent double-door laminoplasty combined with C2 dome decompression from June 2016 to June 2018 were retrospectively analyzed, including 17 males and 11 females, aged 39 to 74 years with an average of (61.0±6.7) years. The clinical effects were evaluated by JOA score, axial symptoms, cervical spine activity, cervical spinal cord compression degree and so on. All patients were followed up for 6 to12 months with an average of 10.2 months. The JOA score in the final follow-up was significantly improved (P<0.05). The range of cervical activity before and after surgery was respectively (41.8±15.3) °, (36.3±18.2) °, and there was no significant difference (P>0.05). After operation, sagittal diameter at the narrowest level of C2-C3 spinal canal was (16.20±1.82) mm, which was significantly higher than (8.38±1.16) mm before operation (P<0.05). There were 4 cases with axial symptoms in 24 patients with the incidence rate of 14.29% (4/24). Double-door laminoplasty combined with C2 dome decompression can directly expand the volume of C2-C3 spinal canal, relieve the compression of spinal cord and nerve root, reduce the damage to the posterior cervical ligament complex as much as possible, maintain the stability of cervical spine sequence, reduce the occurrence of axial symptoms, and the operation is relatively simple, without the need of metal internal fixation.