頚椎症性脊髄症に対する椎弓形成術後の頚椎アライメント片開き式ときょく突起縦割式の比較

Abstract

To determine which laminoplasy should be selected for the treatment of cervical myelopathy due to narrowed canal and multisegmental spondylosis, surgical results, surgical morbidity, postoperative complications, and postoperative cervical alignment of open-door laminoplasty and those of French-window laminoplasty were compared. This retrospective study consisted of 50 patients with cervical multisegmental spondylotic myelopathy who were treated surgically and followed up more than 2 years after surgery. Twenty-five patients underwent open-door laminoplasty, and remaining 25 underwent French-window laminoplasty. The mean preoperative JOA score was 9.8 points in the open-door group and 8.4 points in the French-window group. The mean postoperative JOA score was 13.3 points in the open-door group and 12.4 points in the French-window group. There was no significant difference in the mean preoperative and postoperative JOA score between the two groups. Postoperative transient paralysis of the nerve root occurred in one patient in the open-door group and 3 in the French-window group. The postoperative range of flexion-extension motion significantly decreased in the French-window group than the open-door group. No development of the malalignment of the cervical spine or segmental spinal instability was observed in either group after surgery.