Clinical efficacy of single open-door laminoplasty for the treatment of cervical spondylotic myelopathy with or without spondylolisthesis

LI Fei-hu; WANG Qian; HAO Ding-jun; WU Qi-ning; FAN Yong; LIU Shi-chang; CHEN Guo-yong; SHI Dan-dan

doi:10.3969/j.issn.2095-252X.2018.02.007

Abstract：Objective To compare the clinical effects of single open-door laminoplasty for cervical spondylotic myelopathy with or without spondylolisthesis. Methods A retrospective analysis was performed on 57 patients ( 33 males, 24 females ) with cervical spondylotic myelopathy. All patients were treated by single open-door laminoplasty in our hospital from July 2012 to September 2015. The mean age was 62.6 years ( range: 47 -79 years ). All patients were divided into Non-spondylolisthesis Group ( Group A ) and Spondylolisthesis Group ( Group B ). Visual analogue scale ( VAS ) and Japanese orthopaedic association ( JOA ) were compared between the two groups before and after the operation. Distance and the degree of instability of the cervical spine were compared with those of the Spondylolisthesis Group ( Group B ) before and 2 years after the operation. Results All patients were followed up at the mean of ( 3.6 ± 1.5 ) years ( range: 2.1 - 4.1 years ). The mean age of Group B ( 66.7 years ) was significantly older than that of Group A ( 58.5 years ) ( P < 0.05 ). JOA score increased from ( 9.8 ± 2.4 ) preoperatively to ( 12.4 ± 2.2 ) 2 years postoperatively in Group A, while from ( 8.3 ± 2.3 ) to ( 12.3 ± 2.1 ) in Group B with statistical significance ( P < 0.05 ). However, There were no significant differences in the improvement rate of JOA scores between the two groups(51.5% vs.49.2%)(P=0.780).VAS score decreased from(4.8 ± 1.2) preoperatively to ( 1.9 ± 1.1 ) 2 years postoperatively in Group A, while from ( 4.9 ± 1.1 ) to ( 1.9 ± 1.0 ) in Group B with statistical significance ( P < 0.05 ). The average distance of spondylolisthesis was ( 3.5 ± 1.1 ) mm preoperatively and ( 3.2 ± 1.0 ) mm 2 years postoperatively in Group B with no statistical significance ( P = 0.610 ). Unstable cervical spondylolisthesis degree decreased from ( 1.2 ± 0.8 ) mm preoperatively to ( 0.7 ± 0.4 ) mm postoperatively with statistical significance ( P < 0.05 ). Conclusions Cervical degenerative spondylolisthesis is common in cervical spondylotic myelopathy, especially in the elderly. Similar effects can be achieved by single open-door laminoplasty in the treatment of cervical spondylotic myelopathy with or without spondylolisthesis, which is feasible and effective.