Open AccessLongitudinal Spinous‐Splitting Laminoplasty with Coral Bone for the Treatment of Cervical Adjacent Segment Degenerative Disease: A 5‐Year Follow‐up Study
Author(s) -
He Wei,
He Da,
Wang Qilong,
Tian Wei,
Liu Bo,
Liu Yajun,
Sun Yuqing,
Xing Yonggang,
Yuan Ning,
Yuan Qiang,
Xiao Bin,
Han Bing,
Wang Yumei,
Ma Tengfei,
Liu Mingming
Publication year - 2022
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.13027
Subject(s) - medicine , corpectomy , surgery , laminoplasty , anterior cervical discectomy and fusion , degenerative disc disease , neck pain , visual analogue scale , radiography , cervical vertebrae , cervical spine , myelopathy , lumbar , spinal cord , alternative medicine , pathology , psychiatry
This study was designed to analyze the causes of cervical adjacent segment degenerative disease (ASDis), evaluate the surgical outcomes of longitudinal spinous‐splitting laminoplasty with coral bone (SLAC) during cervical reoperation, and accumulate data on reoperation with SLAC in a primary hospital. Based on the inclusion and exclusion criteria, we conducted a retrospective study involving 52 patients who underwent cervical reoperation for ASDis using SLAC at the spinal surgery department of the Beijing Jishuitan Hospital from 1998 to 2014. Among them, 39 were treated with anterior cervical fusion and internal fixation during the first operation (anterior cervical corpectomy with fusion [ACCF], n = 24; anterior cervical discectomy and fusion [ACDF], n = 11; and cervical disc arthroplasty [CDA], n = 4). Outcomes were the Japanese Orthopaedic Association (JOA) score, neck disability index (NDI) score, upper limb/neck and shoulder evaluated using a visual analogue scale (VAS), and rates of ASDis. In patients who underwent an anterior cervical approach in the first instance, the incidence of ASDis was significantly higher in the C 3/4 gap than in the other gaps. In the ACCF group, the lateral radiograph of the cervical spine revealed that the distance between the anterior cervical plate and the adjacent segment disc was <5 mm in 15 (62.5%) cases and five (12.8%) cases, respectively, the internal fixation screws broke into the annulus of the adjacent segment. After the first SLAC, ASDis developed at C 2/3 and C 3/4 in four (30.8%) and eight (61.5%) cases, respectively. After reoperation, all cases were followed up for >5 (average, 6.2) years. The pre‐reoperation and last follow‐up values were as follows: mean Japanese Orthopaedic Association score, 10.2 ± 1.5 vs 15.5 ± 0.7 ( P = 0.03); neck disability index, 26.2 vs 13.6 points ( P = 0.01); upper‐limb visual analog scale (VAS) score, 6.1 vs 2.6 points ( P = 0.04); and neck and shoulder VAS score, 6.6 vs 2.1 points ( P = 0.03). SLAC is a simple technique in which the local anatomy is clearly visible and satisfactory clinical outcomes are obtained.