Posterior cervical single door and double door laminoplasty for repair of multilevel cervical myelopathy：motion range of cervical vertebrae

Liang He-sheng; Xiao Li-jun; Deng De-li

doi:10.3969/j.issn.2095-4344.2016.22.006

Abstract：BACKGROUND:Previous studies on posterior cervical single door and double door laminoplasty for repair of multilevel cervical myelopathy mainly focus onneurological function and clinical parameters and lack of certain comprehensiveness. <br> OBJECTIVE:To explore the effects of posterior cervical single door and double door laminoplasty for repair of multilevel cervical myelopathy. <br> METHODS:We selected 120 patients with multilevel cervical myelopathy and randomly divided into single door group (n=60) and double door group (n=60). The single door group underwent single door laminoplasty. The double door group underwent double door laminoplasty. The blood loss,length of stay, complication rate, neurological function improvement, motion range of cervical vertebrae and imaging changes were compared between the two groups. <br> RESULTS AND CONCLUSION:(1) Blood loss was significantly less, length of stay was significantly shorter, and the incidence of axial symptom was significantly reduced in the double door group than in the single door group (alP< 0.05). (2) No significant difference in complication rate such as side leakage of cerebrospinal fluid, hematoma, infection and paralysis was detected between the two groups (P> 0.05). The incidence of axial symptoms was significantly less in the double door group than in the single door group (P< 0.05). (3) There were no significant differences in preoperative Japanese Orthopaedic Association scores, postoperative Japanese Orthopaedic Association scores, and improvement in neurological function between the two groups (P> 0.05). Postoperative Japanese Orthopaedic Association scores were significantly increased as compared with that preoperatively in both groups (P<0.05). (4) No significant difference in motion range of cervical vertebrae, inflexion, extension angle and sagittal diameter of spinal canal was detectable between the two groups (P> 0.05). Motion range of cervical vertebrae, extension angle, and inflexion angle were smaler after treatment compared with that preoperatively in both groups (P< 0.05). The increased degree of sagittal diameter of spinal canal was smaler, and the motion range of cervical vertebrae kept better in the double door group than in the single door group. (5) These results indicate that the effect of double door laminoplasty for repair of multilevel cervical myelopathy was significant. The double door laminoplasty can shorten the length of stay, reduce blood loss, axial symptoms, and loss rate of motion range of the cervical vertebrae. In the clinic, treatment can be carried out according to different indications.