颈椎后路椎管减压节段范围对脊髓后方漂移幅度的影响（英文）

【作者】 孔清泉； 张立； 李涛； 龚全； 曾建成； 宋跃明； 刘浩； 王少波； 孙宇； 张凤山； 李迈； 陈仲强；

【机构】 四川大学华西医院骨科； 北京大学第三医院；

【摘要】 [Design]A retrospective study to analyze the effect of decompressive scope on spinal cord posterior shift after expansive open-door laminoplasty（ELAP）.[Objective]To investigate the effect of decompressive scope on cord shift distance after ELAP,and determine the morphologic limitations of posterior approach,when the cervical alignment is lordotic or staight.[Background]It is not agreeable on the effect of space available for spinal cord at the level cepahlad to the decompression with cord shift until now.Moreover,little is understood regaring the significance of decompressive scope of laminoplasty in relation to spinal cord shift and clinical outcome.[Methods]Preoperative and postoperative MRIs of 76 patients with a straight or lordotic cervical spine who had undergone cervical laminoplasty were reviewed retrospectively.Radiographic parameters including cervical sagittal alignment,space available at the level cepahlad,the thickness of compressive element,and the average anteriorcord space were measured.Laminoplasty was performed from C₁ to C₇ in 11 cases（C I group）,C₂ to C₇ in 30 cases（CⅡgroup）,and C₃ to C₇ in 35 cases（CⅢgroup）.The recovery rate based on the JOA score was calculated for each patient.[Results]There were statistically significant differences in the average anterior cord space among CⅠ,CⅡand CⅢgroups（P<0.05）;the average anterior cord space was the largest in C I group,and the smallest in C group.The space available at the level cepahlad had strong sigmoidal correlation with cord postoperative shift in CⅢgroup{R²=O.91,y=2.9+3.7/[1+EXP[[1.95-x]/0.13]]}[Conclusion]The posterior decompression scope is a main factor affecting cord shift distance after laminoplasty in the context of a straightened or lordotic cervical curvature.The space available at the levels cepahlad is a key factor to predict cord shift distance in laminoplasty from C3 to c7.更多还原

【Abstract】 [Design]A retrospective study to analyze the effect of decompressive scope on spinal cord posterior shift after expansive open-door laminoplasty（ELAP）.[Objective]To investigate the effect of decompressive scope on cord shift distance after ELAP,and determine the morphologic limitations of posterior approach,when the cervical alignment is lordotic or staight.[Background]It is not agreeable on the effect of space available for spinal cord at the level cepahlad to the decompression with cord shift until now.Moreover,little is understood regarding the significance of decompressive scope of laminoplasty in relation to spinal cord shift and clinical outcome.[Methods]Preoperative and postoperative MRIs of 76 patients with a straight or lordotic cervical spine who had undergone cervical laminoplasty were reviewed retrospectively.Radiographic parameters including cervical sagittal alignment,space available at the level cepahlad,the thickness of compressive element,and the average anterior cord space were measured.Laminoplasty was performed from C₁ to C₇ in 11 cases（CⅠ group）,C₂ to C₇ in 30 cases（C Ⅱ group）,and C₃ to C₇ in 35 cases（CⅢ group）.The recovery rate based on the JO A score was calculated for each patient.[Results]There were statistically significant differences in the average anterior cord space among C Ⅰ,C Ⅱ and CⅢ groups（P <0.05）;the average anterior cord space was the largest in C I group,and the smallest in C Ⅲ group.The space available at the level cepahlad had strong sigmoidal correlation with cord postoperative shift in CⅢ group { R² = 0.91,y =2.9 +3.7/[l +EXP[[1.95-x]/0.13]]}.[Conclusion]The posterior decompression scope is a main factor affecting cord shift distance after laminoplasty in the context of a straightened or lordotic cervical curvature.The space available at the levels cepahlad is a key factor to predict cord shift distance in laminoplasty from C₃ to_C7.更多还原