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Expansion of Spinal Canal with Lift‐Open Laminoplasty: A New Method for Compression Cervical Myelopathy

OBJECTIVE: This study is to introduce lift‐open laminoplasty and verify the increase of the spinal canal area following this surgical technique according to the preoperative anatomical measurement. METHODS: There are 82 patients (43 male and 39 female) analyzed in our study from January 2019 to Dece...

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Autores principales: Wang, Huan, Zhang, Lei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313177/
https://www.ncbi.nlm.nih.gov/pubmed/34109741
http://dx.doi.org/10.1111/os.13026
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author Wang, Huan
Zhang, Lei
author_facet Wang, Huan
Zhang, Lei
author_sort Wang, Huan
collection PubMed
description OBJECTIVE: This study is to introduce lift‐open laminoplasty and verify the increase of the spinal canal area following this surgical technique according to the preoperative anatomical measurement. METHODS: There are 82 patients (43 male and 39 female) analyzed in our study from January 2019 to December 2020. The average age was 63.2 ± 3.21 years (from 41 to 84 years). All of them were treated with open‐door laminoplasty, with a decompression segment range from C3 to C6. The increase of the spinal canal area after open‐door laminoplasty was measured on postoperative CT images of the patients, and the distances between both lamina‐facet junctions and lamina length was measured on preoperative CT images. Using the Pythagorean theorem for the equation of calculation area after the expansile open‐door laminoplasty. Based on previous measurement parameters, spinous process length, lateral mass width, distance between osteotomy line and lamina‐facet junctions line were additionally measured on preoperative CT images. Pythagorean theorem was used for calculating the area after the expansile lift‐open laminoplasty. The results were recorded and a statistical analysis was undertaken. Then, there were six patients (five male and one female) treated with lift‐open laminoplasty on C6, open‐door on C3–C5, who suffer from cervical spondylotic myelopathy from December 2020 to January 2021. The average age was 60.3 ± 1.7 years (from 56 to 71 years). Operation time, blood loss, and Japanese Orthopaedic Association (JOA) score recovery rate were recorded. Intraoperative and postoperative complications were observed. RESULTS: The increase of the spinal canal area after open‐door laminoplasty measured on postoperative CT images was 123.01 ± 17.06 mm(2) and the calculation of the increase of the spinal canal areausing the Pythagorean theorem after open‐door laminoplasty was 122.86 ± 15.86 mm(2). A comparison of the actual value with calculative value showed no significant difference (T value = 0.057, P value = 0.955). The calculation of the increase of the spinal canal area after lift‐open laminoplasty was 183.57 ± 62.99 mm(2), which was larger than that after open‐door laminoplasty (T value = 8.462, P value < 0.001). Mean operation time was 153.3 min and operative blood loss was 600 mL of the six patients treated with lift‐open laminoplasty. At 1 month follow‐up, all patients had recovered well. JOA score recovery rate was 37.6% and no intraoperative and postoperative complications occurred. CONCLUSION: Lift‐open laminoplasty could preserve nearly 100% of extensor muscle, avoid damaging C7 paraspinal muscles and C6‐7 posterior muscle‐ligament complex, reconstruct the spinous process firmly in the midline, and expand adequate spinal canal area after operation. These advantages could reduce the incidence rate of complications and bring better clinical results than traditional laminoplasty.
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spelling pubmed-83131772021-07-30 Expansion of Spinal Canal with Lift‐Open Laminoplasty: A New Method for Compression Cervical Myelopathy Wang, Huan Zhang, Lei Orthop Surg Operative Techniques OBJECTIVE: This study is to introduce lift‐open laminoplasty and verify the increase of the spinal canal area following this surgical technique according to the preoperative anatomical measurement. METHODS: There are 82 patients (43 male and 39 female) analyzed in our study from January 2019 to December 2020. The average age was 63.2 ± 3.21 years (from 41 to 84 years). All of them were treated with open‐door laminoplasty, with a decompression segment range from C3 to C6. The increase of the spinal canal area after open‐door laminoplasty was measured on postoperative CT images of the patients, and the distances between both lamina‐facet junctions and lamina length was measured on preoperative CT images. Using the Pythagorean theorem for the equation of calculation area after the expansile open‐door laminoplasty. Based on previous measurement parameters, spinous process length, lateral mass width, distance between osteotomy line and lamina‐facet junctions line were additionally measured on preoperative CT images. Pythagorean theorem was used for calculating the area after the expansile lift‐open laminoplasty. The results were recorded and a statistical analysis was undertaken. Then, there were six patients (five male and one female) treated with lift‐open laminoplasty on C6, open‐door on C3–C5, who suffer from cervical spondylotic myelopathy from December 2020 to January 2021. The average age was 60.3 ± 1.7 years (from 56 to 71 years). Operation time, blood loss, and Japanese Orthopaedic Association (JOA) score recovery rate were recorded. Intraoperative and postoperative complications were observed. RESULTS: The increase of the spinal canal area after open‐door laminoplasty measured on postoperative CT images was 123.01 ± 17.06 mm(2) and the calculation of the increase of the spinal canal areausing the Pythagorean theorem after open‐door laminoplasty was 122.86 ± 15.86 mm(2). A comparison of the actual value with calculative value showed no significant difference (T value = 0.057, P value = 0.955). The calculation of the increase of the spinal canal area after lift‐open laminoplasty was 183.57 ± 62.99 mm(2), which was larger than that after open‐door laminoplasty (T value = 8.462, P value < 0.001). Mean operation time was 153.3 min and operative blood loss was 600 mL of the six patients treated with lift‐open laminoplasty. At 1 month follow‐up, all patients had recovered well. JOA score recovery rate was 37.6% and no intraoperative and postoperative complications occurred. CONCLUSION: Lift‐open laminoplasty could preserve nearly 100% of extensor muscle, avoid damaging C7 paraspinal muscles and C6‐7 posterior muscle‐ligament complex, reconstruct the spinous process firmly in the midline, and expand adequate spinal canal area after operation. These advantages could reduce the incidence rate of complications and bring better clinical results than traditional laminoplasty. John Wiley & Sons Australia, Ltd 2021-06-10 /pmc/articles/PMC8313177/ /pubmed/34109741 http://dx.doi.org/10.1111/os.13026 Text en © 2021 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Operative Techniques
Wang, Huan
Zhang, Lei
Expansion of Spinal Canal with Lift‐Open Laminoplasty: A New Method for Compression Cervical Myelopathy
title Expansion of Spinal Canal with Lift‐Open Laminoplasty: A New Method for Compression Cervical Myelopathy
title_full Expansion of Spinal Canal with Lift‐Open Laminoplasty: A New Method for Compression Cervical Myelopathy
title_fullStr Expansion of Spinal Canal with Lift‐Open Laminoplasty: A New Method for Compression Cervical Myelopathy
title_full_unstemmed Expansion of Spinal Canal with Lift‐Open Laminoplasty: A New Method for Compression Cervical Myelopathy
title_short Expansion of Spinal Canal with Lift‐Open Laminoplasty: A New Method for Compression Cervical Myelopathy
title_sort expansion of spinal canal with lift‐open laminoplasty: a new method for compression cervical myelopathy
topic Operative Techniques
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313177/
https://www.ncbi.nlm.nih.gov/pubmed/34109741
http://dx.doi.org/10.1111/os.13026
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