Short-term Curative Effect Of The Treatment Of Multi-segment Cervical Spondylotic Myelopathy With A Single-door Opener Centerpiece Titanium Plate

Objective:To investigation the clinical curative effect of multi-segmental cervical spondylotic myelopathy treated by posterior unilateral open-door laminoplasty combined with Centerpiece titanium plate internal fixation.Methods:From September 2015 to December 2017,we chose36 patients,in which18 were males and 18 were females,with multi-segmental spondylotic myelopathy who were treated by posterior unilateral open-door laminoplasty and Centerpiece titanium plate internal fixation,aged 38-79 years,average(59.72±9.17)years.Clinical manifestation of the patients showed varying degrees of double upper limb numbness and pain,unstable holding and tread on cotton,accompanied by bottom-up upper motor neurons injury,preoperative CT or MRI showed three or more than three levels lesion in all cases,all the patients were diagnosed as MCSM by clinic,X-rays,CT and MRI.The operating time,intraoperative blood loss,intraoperative transfusion volume and surgical complications were recorded detailedly.All the cases were follow-up,the change of spinal canal was checked by CT in 3 and 6 months after the operation,and the postoperative recovery were asked detailedly.The JOA score,the improvement rate of JOA and the VAS score were record before and after 3 or 6 monthes of the opera.Alignment of the cervical spine and cervical range of motion were recorded preoperative and postoperative respectively.Results:All the patients underwent the operation.The average surgery time was(271.22±41.51)min ranging from 220 to 400 min.The average blood loss was(502.78±260.20)mL ranging from 200 to 1200 mL.The transfusion volume inoperative was(2030.56±513.71)mL ranging from 1100～2600 mL.The irrevisible neurological injury,cerebrospinal fluid leakage,infection and break of internal fixation were not found inoperative.After following up 6 months,axial symptoms occurred in two patients.At 3 month after operation,the JOA score was(13.5±0.94)which there was a significant difference(P<0.05)from the(8.61 ± 1.50)before operation,the improvement rate of JOA was 56.77%,at 6 month after operation,the JOA score was(15.19±0.67)which there was a significant difference(P<0.05)from it was at 3 month and before operation,the improvement rate of JOA was 76.45%;At 3 month after operation,the VAS score was(2.22±0.72)which there was a significant difference(P<0.05)from the(4.92±1.68)before operation,at 6 month after operation,the VAS score was(1.44±0.50)which there was a significant difference(P<0.05)from it was at 3 month and before operation;there was no significant difference(P>0.05)in the alignment of the cervical spine which were(27.65± 1.03)and(26.75± 1.06);there was no significant difference(P>0.05)in the cervical range of motion which were(38.42±5.53)and(36.67±5.29).Conclusion:Posterior unilateral open-door laminoplasty combined with Centerpiece titanium plate internal fixation is efficient in improving the symptoms,maintaining the alignment of the cervical spine and the cervical range of motion,which is a safe and effective method in the treatment of multi-segmental cervical spondylotic myelopathy.