Analysis of Short-Term Prognostic Factors of Posterior Single Open-Door Laminoplasty in Patients with Cervical Spondylotic Myelopathy

被引：0
作者：
Sun, Yi [1 ]
Ye, Jun [2 ]
Qiu, Junjie [1 ]
机构：
[1] First Peoples Hosp Tongxiang City, Dept Painol, Tongxiang 314500, Zhejiang, Peoples R China
[2] Blood Ctr Zhejiang Prov, Blood Donat Serv Sect 2, Hangzhou 310000, Zhejiang, Peoples R China
来源：
ANNALI ITALIANI DI CHIRURGIA | 2024年 / 95卷 / 06期
关键词：
expansive open-door laminoplasty; cervical spondylotic myelopathy; prognosis; LONGITUDINAL LIGAMENT; SURGICAL OUTCOMES; ANTERIOR; DECOMPRESSION; FUSION; OSSIFICATION; ASSOCIATION; CORPECTOMY; SCALE;
D O I：
10.62713/aic.3599
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
AIM: Posterior cervical expansive open-door laminoplasty (ELAP) is one of the main methods for the treatment of multilevel cervical spondylotic myelopathy (CSM). However, some patients are vulnerable to developing complications such as kyphosis and axial symptoms after ELAP, potentially facing adverse prognosis following the procedure. At present, there are few reports on the short-term prognostic factors in Chinese patients with CSM after undergoing ELAP. The main objectives of this study are to investigate the efficacy of ELAP in the treatment of CSM and to analyze the short-term prognostic factors. METHODS: This study is a retrospective study. A total of 98 patients with CSM who received ELAP surgery in The First People's Hospital of Tongxiang City from May 2021 to October 2022 were selected as the study participants. The clinical efficacy of the ELAP was evaluated using visual analog scale (VAS), Japanese Orthopedic Association (JOA) score, and assessments based on imaging indicators. All patients were followed up for 1 year postoperatively. The short-term prognosis was analyzed according to JOA improvement rate, and the short-term prognostic factors were analyzed using multivariate logistic regression. RESULTS: The JOA scores of 98 CSM patients at 1 year after operation were significantly higher than those before operation (p< 0.001), and their postoperative VAS score were significantly lower than those before operation (p < 0.001). The postoperative cervical curvature (p < 0.001), sagittal diameter of cervical spinal canal (p < 0.001) and distance between vertebral body and posterior edge of spinal cord (p < 0.001) were significantly improved relative to the corresponding preoperative values. There was no significant difference in cervical 2-7 Cobb angle before and after operation (p = 0.979). Multivariate logistic regression analysis showed that age (p < 0.001), course of disease (p < 0.001) and preoperative JOA score (p < 0.001) were independent risk factors affecting the short-term prognosis in CSM patients. CONCLUSIONS: ELAP is a safe and effective therapeutic approach for CSM, whose short-term prognosis is related to age, course of disease and preoperative JOA score.
引用
收藏
页码：1118 / 1124
页数：7
相关论文
共 21 条
  • [1] Lu CB, Ma ZS, Hu JB, Yang XJ, Wei W, Zhang Y, Et al., Evaluation of Anterior Decompression Surgical Outcomes of Proximal-Type Cervical Spondylotic Amyotro-phy: A Retrospective Study, Orthopaedic Surgery, 12, pp. 734-740, (2020)
  • [2] Diao YZ, Yu M, Zhang FS, Sun Y, Wang SB, Zhang L, Et al., Effect of decompression range on decompression limit of cervical laminoplasty, Chinese Medical Journal, 133, pp. 909-918, (2020)
  • [3] Youssef JA, Heiner AD, Montgomery JR, Tender GC, Lorio MP, Morreale JM, Et al., Outcomes of posterior cervical fusion and decompression: a systematic review and meta-analysis, The Spine Journal: Official Journal of the North American Spine Society, 19, pp. 1714-1729, (2019)
  • [4] Karamzadeh M, Al Samman MM, Vargas AI, Bhadelia RA, Oshinski J, Barrow DL, Et al., The Effect of Posterior Fossa Decompression Surgery on Brainstem and Cervical Spinal Cord Dimensions in Adults with Chiari Malforma-tion Type 1, World Neurosurgery, 180, pp. 149-154, (2023)
  • [5] El-Ghandour NMF, Soliman MAR, Ezzat AAM, Mohsen A, Zein-Elabedin M., The safety and efficacy of anterior versus posterior decompression surgery in degenerative cervical myelopathy: a prospective randomized trial, Journal of Neurosurgery. Spine, 33, pp. 288-296, (2020)
  • [6] Oe S, Kurosu K, Hasegawa T, Shimizu S, Yoshida G, Fujita T, Et al., Risk Factors for Cervical Deformity After Posterior Cervical Decompression Surgery: A Multicenter Study, Global Spine Journal, 13, pp. 1457-1466, (2023)
  • [7] Tian A, Gao H, Wang Z, Li N, Ma J, Guo L, Et al., Brain structural correlates of postoperative axial pain in degenerative cervical myelopathy patients following posterior cervical decompression surgery: a voxel-based morphometry study, BMC Medical Imaging, 23, (2023)
  • [8] Liu Y, Luo X, Zhou J, Li N, Peng S, Rong P, Et al., Prognosis of posterior osteophyte after anterior cervical decompression and fusion in patients with cervical spondylotic myelopathy using three-dimensional computed tomogra-phy study, European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 25, pp. 1861-1868, (2016)
  • [9] Lu CB, Yang XJ, Wu JC, Lin YZ, Sang HX., Clinical In-vestigation of the Association of Opening Size with Sagittal Canal Diameter Based on Single-Door Cervical Lamino-plasty, Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 25, pp. 7370-7375, (2019)
  • [10] Tetreault L, Kopjar B, Nouri A, Arnold P, Barbagallo G, Bartels R, Et al., The modified Japanese Orthopaedic Association scale: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy, European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 26, pp. 78-84, (2017)
123