Treatment Of Cervical Spinal Stenosis With Expansive Laminoplasty

Objective To investigate the clinical efficacy of (unilateral /bilateral )expansive laminoplasty in the treatment of cervical spinalstenosis.Method 92 patients with cervical spinal stenosis includingossification of the posterior longitudinal ligament(OPLL) 18 cases;cervical disk herniation 15 cases, OPLL or/and cervical diskherniation with ossification of the flava ligament(OFL) 54 cases,congenital cervical spinal stenosis 5 cases were managed withunilateral or bilateral expansive laminoplasty in our hospital fromNovember 1998 to November 2004. All the patients were followedup. Unilateral expansive open-door laminoplasty was used in 35cases, bilateral expansive open-door laminoplasty in 57 cases. Thespinal function recovery or improvement rates were analyzed byJapanese Orthopedic Association(JOA) score system.Result The follow-up period of the 92 cases ranged from 0.5to 6.5 years with an average of 2 years. Recovery or improvementof spinal function was found in most patients. The results wereevaluated with JOA score system, the average improvement rate ofunilateral and bilateral expansive open-door laminoplasty was61.6% and 63.9% separately; Excellent and good result wasachieved in 88.6% and 91.2% separately. There was no obviousdifference in spinal function recovery in the treatment of unilateraland bilateral expansive open-door laminoplasty (P>0.05) bystatistics analysis. The total average improvement rate was 63.0%,excellent and good rate was 90.2% by JOA score system, soexpansive laminoplasty of cervical spine is an effective method fortreating cervical spinal stenosis. Conclusions We can expand sagittal diameter of intraspinalcanal, relieve spinal pressure directly and keep the steadiness ofcervical vertebra by expansive laminoplasty of cervical spine, theoperation is simple, less dangerous, and need no special instrument,so it is an effective method for treating cervical spinal stenosis.Both unilateral and bilateral expansive open-door laminoplastyhave their own strongpoints and shortcomings, no difference inspinal function improvement was found (P >0.05), it's difficult tosay which one is better. Before the operation technic was designed,...