Summary
The long term effects of laminoplasty on cervical movement and alignment were investigated by radiography and CT scans in a study of 56 patients with multisegmental myelopathy who had undergone a C3 to C7 open-door laminoplasty. Follow up averaged 5.8 years. Satisfactory neurological improvement occurred in 73%. Cervical flexion decreased by 35% and extension by 57%; the decrease of both movement was statistically significant. Decreased vertebral slip, as well as slightly reduced lordosis, was seen after operation. Increase in measured canal size after operation and at follow up was 48% and 40%; 8% of the expanded canal size was lost at the last follow up. Expansive open-door laminoplasty leads to a better neurological prognosis in this group of patients, while maintaining an increase in canal size and preserving spinal stability.
Résumé
Les effets à long terme de la laminoplastie sur la mobilité et l'alignement du rachis cervical ont été étudiés par radiographie et tomodensitométrie. Le travail a porté sur 56 patients atteints de myélopathie spondylitique multisegmentaire, ayant subi une laminoplastie ouverte C3–C7 avec une greffe osseuse réalisant un espaceur autogène. Le recul est en moyenne de 5.8 ans (de 2 à 10.4) et les résultats ont montré une amélioration neurologique satisfaisante dans 73% des cas. La flexion était diminuée de 35% et l'extension de 57%. Cette diminution de la mobilité était statistiquement significative. On a également observé une réduction du glissement vertébral et une légère réduction de la lordose. L'augmentation de la taille du canal après l'intervention chirurgicale était de 48% et de 40% au dernier examen; à ce moment elle avait disparu dans 8% des cas. Les laminoplasties ouvertes étendues assurent un meilleur pronostic neurologique chez les patients atteints de spondylite multisegmentaire en maintenant la taille du canal et en préservant la stabilité vertébrale.
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Baba, H., Maezawa, Y., Furusawa, N. et al. Flexibility and alignment of the cervical spine after laminoplasty for spondylotic myelopathy. International Orthopaedics 19, 116–121 (1995). https://doi.org/10.1007/BF00179972
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DOI: https://doi.org/10.1007/BF00179972