Single Open Door Laminoplasty With Micro Titanium Plate For The Treatment Of Cervical Spondylotic Myelopathy

Objective: To investigate the open-door laminoplasty clinical effect with micro titanium plate fixation for the treatment of CSM.Methods: From January 2013 to March 2014,49 cases with CSM undergoing surgical treatment were retrospectively reviewed., male 37 cases, female 12 cases, the average age was 60.2 ± 2.6 years(range from 56-71 years old). They were randomly divided into two groups, one group for posterior cervical open-door laminoplasty, fixed with micro titanium plate, micro titanium plate fixation group; a group underwent posterior open-door, fixed with thick silk suture, rough suture fixation group. Micro titanium plate fixation group male 20 cases, female 5 cases, rough suture fixation group male 17 cases, female 7 cases. Patients in the postoperative three month, six months, twelve months out-patient review, review the content mainly for inquiry and record the patient’s own feeling, the doctor check body signs, conventional filming cervical X-ray, CT, MRI inspection, measuring the anteroposterior diameter of the spinal canal index, measuring the opening angle,(Fig.1.1-1.2) assess canal expansion rate, and preoperative index contrast, using(JOA score) evaluation of nerve function, the highest score of 17 points, higher scores indicate more light, nerve function damage.Results: Micro titanium plate fixation group: Canal enlargement rate of 32.6%±1.0%, the average JOA score before operation was(7.4 ± 1.9), at the time of the latest follow-up for(13.2 ± 1.8), improvement rate was 62.3%. 3 patients after the operation of axial symptom, 1 patient after the operation happened C5 palsy,and improved after symptomatic treatment; There was no screw loosening, micro titanium plate displacement, door side bone collapse again the compression of the spinal cord and other complications at the latest follow-up. Thick silk suture fixation group: Canal enlargement rate of 29.8%±1.5%, the mean preoperative JOA score(8.3±1.4), at the time of the latest follow-up for(12.6±1.8), improvement rate was 52.3%. 3 cases occurred "door reclosure" phenomenon, axial symptoms appeared in 1 patients, 2 patients after the operation happened C5 palsy, improved after symptomatic treatment; no delayed wound healing phenomenon happened.Conclusion: Cervical posterior single open-door laminoplasty using micro titanium plate fixation is stable, can prevent from postoperative lamina elastic recoil due to unstable fixation, can effectively maintain the single open door operation after the opening angle, to prevent the "door reclosure" phenomenon, to prevent the loss of cervical curvature, reduce axial symptoms, is an effective method for the treatment of cervical spondylotic myelopathy.