Abstract
ObjectiveThe effects of dural release on extended laminoplasty for the treatment of multi-level cervical myelopathy were explored and discussed.MethodPatients, who underwent extended laminoplasty combined with dural release for the treatment of multi-level cervical myelopathy (35 cases, group A), were compared with patients who underwent simple extended laminoplasty (38 cases, group B). The JOA score, improvement rate, VAS score, distance of retroposition of the spinal cord, cervical lordosis were compared between the two groups.ResultsDural laceration occurred to five patients during surgery, three in group A and two in group B; cerebrospinal fluid leakage occurred to five patients, three in group A and two in group B. All patients were followed up for 10 to 48 months (mean 20.3 months). JOA scores and VAS scores in the last follow up period were significantly improved in the two groups than preoperative scores (p < 0.05). The improvement rate and JOA scores in group A were significantly higher than group B, while VAS scores in group A were significantly lower than group B (p < 0.05). There were no significant differences in cervical lordosis in the two groups in the last follow up (p > 0.05), and the distance of retroposition of the spinal cord in group A was higher than B (p < 0.05). No shut-up of the ‘door’ of vertebral lamina occurred in the period of follow-up.ConclusionDural release on extended laminoplasty can achieve retroposition of the spinal cord for multi-level cervical myelopathy, which is more effective than simple extended laminoplasty.
Highlights
Multi-level cervical myelopathy is a progressive disease that needs surgery for improvement, and it is a potential destructive nerve disorder resulting from spinal cord injury that is related to degeneration of the discs and other supporting spinal column structures [1]
The improvement rate and JOA scores in group A were significantly higher than group B, while VAS scores in group A were significantly lower than group B (p < 0.05) (Table 1)
Imaging diagnosis There were no significant differences in cervical lordosis in the two groups in the last follow up (p > 0.05), and the distance of retroposition of the spinal cord in group A was higher than B in the last follow up (t = 7.256, p < 0.001) (Table 2)
Summary
Multi-level cervical myelopathy is a progressive disease that needs surgery for improvement, and it is a potential destructive nerve disorder resulting from spinal cord injury that is related to degeneration of the discs and other supporting spinal column structures [1]. There are various surgical procedures used in the treatment of patients with multi-level cervical myelopathy, including cervical laminoplasty, cervical. It is rare for the report about whether dural release will affect retroposition of the spinal cord and the efficacy of cervical myelopathy after posterior extended laminoplasty. We analyzed the data of 35 patients who underwent extended laminoplasty with dural release from September 2012 to December 2014, and compared with the data of.
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