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首页> 外文期刊>Open Journal of Modern Neurosurgery >Clinical Outcome after Laminectomy without Fusion for Cervical Spondylotic Myelopathy
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Clinical Outcome after Laminectomy without Fusion for Cervical Spondylotic Myelopathy

机译：椎板切除不融合治疗颈椎病性脊髓病的临床疗效

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Dorsal decompression in patients, presenting with cervical spondylotic myelopathy with no signs of instability, is a standard surgical option. Laminectomy or laminoplasty is applied to reduce the pressure on the myelon. The aim of this study was to evaluate the clinical outcome in a consecutive series of patients. This retrospective study included a total of 65 patients who underwent laminectomy or laminoplasty at a single or more levels, without fusion for cervical spondylotic myelopathy, during an 8-year period (2000-2007). The clinical data evaluation included pre- and postoperative patient history and neurological and surgical variables. The radiological assessment included MRI, CT, and plain anterior-posterior, lateral, and lateral flexion-extension X-rays. The mean follow-up time was 15 months. Improvement of gait disturbance was documented in 74% of the patients concerned. Radicular pain in the upper limbs (UL) and lower limbs (LL) improved in 87% and 50% of the patients, respectively. Sensory deficits improved in the UL and LL in 76% and 54%, respectively. Motor deficits improved in the UL and LL in 70% and 56% of the patients, respectively. Clinical deterioration after surgery was documented in one patient. Based on our results, laminectomy without fusion can be advocated as a safe and effective surgical strategy to treat cervical spondylotic myelopathy in patients without preoperative instability. In these patients, the occurrence of post-procedural clinical deterioration and instability was low, and overall improvement of neurological deficits and amelioration of radicular pain can be expected in a significant number of patients.
机译：伴有颈椎病性脊髓病且无不稳定迹象的患者背减压是标准的手术选择。椎板切除术或椎板成形术可减少髓鞘的压力。这项研究的目的是评估一系列连续患者的临床结局。这项回顾性研究共纳入65名患者，这些患者在8年期间（​​2000年至2007年）以单个或多个水平进行了椎板切除术或椎板成形术，但未进行融合治疗颈椎病。临床数据评估包括术前和术后患者的病史以及神经和外科变量。放射学评估包括MRI，CT和普通的前后，外侧和外侧屈伸X线检查。平均随访时间为15个月。有74％的患者记录到步态障碍得到改善。分别有87％和50％的患者的上肢（UL）和下肢（LL）的根性疼痛得到改善。 UL和LL的感觉缺陷分别改善了76％和54％。 UL和LL分别有70％和56％的患者运动功能障碍得到改善。记录了一名患者手术后的临床恶化。根据我们的研究结果，不进行融合的椎板切除术可以作为一种安全，有效的手术策略来治疗无术前不稳定的颈椎病性脊髓病。在这些患者中，术后临床恶化和不稳定的发生率很低，并且可以预期在许多患者中神经功能缺损和神经痛的改善总体改善。

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