| The Study for the Clinical Validity of Miniplate Reinforcing Tension Band |
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Byung-Gwan Moon |
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Department of Neurosurgery, Eulji University School of Medicine, Seoul, Korea |
| 경추 중심성 척수 손상의 회복을 위한 소형 플레이트로 보강한 인장 띠형 후궁 성형술의 임상적 유용성에 대한 연구 |
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문병관 |
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을지대학교 의과대학 서울을지병원 신경외과학교실 |
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| Abstract |
Objective: Tension band cervical laminoplasty was applied to promote clinical results of posterior cervical cord decom- pression for cervical central cord syndromes with more than three segmental stenosis and verified surgical efficacy.
Methods: Seventy one patients who underwent miniplate reinforcing tension band laminoplasty by one doctor(BG Moon) from 1995 to 2004 were followed up over 24 months at least after this operation. 15 patients were completed with following up clinical and radiological studies. This technique was consisted of open door laminoplasty reinforcing with a miniplate and maintenance of the tension band properties of spino-ligamentous complex with C2 laminar doming. We evaluated the correlation between clinical and radiological data and recovery rate, the change of postoperative axial pains. Radiological factors related with recovery rate were analyzed with pre and postoperative MRI study regarding to preoperative A-P diameter of spinal canal, cord shifting, compression ratio of spinal cord, and cross sectional area of spinal cord at each motion segment. Statistic significance was analyzed.
Results: Clinical and radiological factors revealed to a statistical significance for recovery rate were duration of sym- ptoms, Pavlov ratio, Preoperative A-P diameter of spinal canal, cord shifting, compression ratio of spinal cord, and cross sectional area of spinal cord(p<0.05 on one way ANOVA). Recovery rate was correlated with trauma evidence, but not a signal change of the spinal cord(p=0.042, p=0.176 on Kruskal-Wallis test). Mean expansion rate of spinal cord and dural sac were calculates with 7.5% and 30.3%. This laminoplasty achieved the satisfactory expansion of stenotic cord and dural sac(p<0.05, paired t-test). The results of postoperative axial pains such as neck pain and shoul- der pain were improved by this technique over 3 months later.
Conclusion: Miniplate reinforcing tension band laminoplasty in the recovery of cervical central cord syndrome with more than three segmental pathologies could be applicable option to promote postoperative clinical results. |
| Keywords:
Miniplate reinforcing tension band laminoplastyㆍCervical central cord syndrome |
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