The Effect Of Modified Posterior Open Cervical Laminoplasty On Cervical Flexion And Extension Range Of Motion

Objective:To investigate the effects of modified posterior cervical spine open-door laminoplasty and conventional posterior cervical spine open-door laminoplasty on postoperative cervical flexion and extension range of motion and neurological function.Method:Retrospectively analyzed 32 cases of multi-segment cervical spondylotic myelopathy treated with micro-titanium plates and posterior single-door laminoplasty in our department.According to different surgical methods,18 cases were divided into traditional group and modified group.Flexion and extension range of motion(ROM),Visual Analogue Scale(VAS)score,Neck Disabilitv Index(NDI)and Japanese Orthopaedic Association scores(JOA)of cervical spondylosis were recorded.The VAS score,NDI index and JOA score of patients at 6 months and 12 months after operation were reviewed.Dynamic X-ray was performed 12 months after operation.ROM and intervertebral bone intervertebral impact of cervical spine were recorded.Results : 32 patients were completed follow-up,the average follow-up time is 12 months.The ROM of cervical spine flexion and extension at 12 months after operation in the modified group was significantly higher than that in the conventional group(P = 0.002).The improvement of neck pain intensity(VAS score,P = 0.010;NDI index,P = 0.028)in the modified group at 12 months after operation was significantly lower than that of the conventional group.One-year postoperative radiographs showed that 6 patients in the traditional group had signs of bone bump.In the modified group,0 was found to have a bone impact with an interlaminar bone impact of 33.3% and 0%,respectively(P = 0.017).In the traditional group,C5 nerve root palsy occurred early in 1 case,while C5 nerve root paralysis did not occur in the modified group(P = 0.37).Conclusion: Modified posterior cervical spine single open laminoplasty is more effective than conventional surgical procedures in preserving flexion and extension activities after cervical spine surgery and preventing interosseous bone impingement and reducing postoperative neck pain.