A Study of the Clinical Outcome of Laminoplasty for Cervical Compressive Myelopathy

PurposeTo evaluate the prognostic factors that affect the surgical outcome of laminoplasty in patients with cervical compressive myelopathy.MethodsThis is a retrospective review of 43 cases of multi-level cervical compressive myelopathy treated operatively with expansive laminoplasty (Itoh surgical technique), from June 1989 to August 2008. The mean follow-up duration was 7 years. The Japanese Orthopaedic Association score, Hirabayashi recovery rate and improvement of Pavlov's ratio were used to assess the clinical results after laminoplasty.ResultsThe mean Japanese Orthopaedic Association score improved from 9.7 to 13.7 points after laminoplasty (p < 0.001), with 65.1% excellent or good results. The Pavlov ratio improved from 0.71 to 0.9 after operation (p < 0.001). Excellent or good surgical outcome is demonstrated in patients aged <70 years.ConclusionLaminoplasty is a viable surgical option for patients with three or more levelsofcervical cord compression. Patients youngerthan 70 years predict a favourable surgical outcome.

中文摘要目的 : 評估那些預後因素能影響患有頸脊髓壓迫症的病人進行椎管擴大術的手術結果。方法 : 本研究回顧分析了43個患有多節段頸脊髓壓迫症的病人，在1989年六月到2008年八月期間，接受了椎管擴大手術(Itoh伊藤外科技術)。平均隨訪時期為七年。使用了日本骨科學會（JOA）評分，平林(Hirabayashi)康復率和頸椎椎管／椎體矢狀徑的比值(巴夫諾夫比值Pavlov's ratio)來評定椎管擴大手術的術後臨床結果。結果 : 接受了椎管擴大手術的病患者，日本骨科學會評分之平均分從9.7分提高到13.7分(p < 0.001)。優良或良好的手術結果達65.1%。此外，巴夫諾夫比值在手術後也從0.71提高到0.9(p < 0.001)。年齡小於70歲的病患者能顯現出優良或良好的手術結果。結論 : 椎管擴大術是一個適用於三或多於三節段頸脊髓壓迫症病患者的外科手術。病人年齡小於70歲有良好的術後臨床結果。