변형된 방법의 경추부 척추관 확장술의 수술 결과 비교

초록

The Hirabayashi's open-door laminoplasty was good procedure to treat patients with myelopathy in cervical spine but the authors have experienced the problems to maintain open-window in cervical spine undergoing surgery. The authors have developed the modified method of expanded open-door laminoplasty and compared the radiological and surgical findings with classical methods. 방법 The open-window of the cervical spine in the modified methods was supported with wiring fixation utilizing contralateral-side lateral mass screw in stead of fixing paraspinal muscle or facet joint in classicalmethods. Ten patients with cervical myelopathy had been performed classical methods and four consecutive patients have been treated with this modified method. Clinical condition was assessed with the Japanese Orthopaedic Scoring(JOS) System, radiological results were compared with preoperative and postoperative CT findings. 결과 In both methods, clinical results evaluated with JOS system, revealed a significant improvement of neurological function. Image analysis revealed that the cervical canals were continuously expanded in modified methods but open window were repositioned to preoperative place in 4 case of the original methods during follow-up periods. The recovery rate was not different to surgical results of any other papers. Radiographically, progression to deformity or spinal instability were not observed in any patient. 결론 Although analysis with a larger population and a longer follow-up period needs to be undertaken, our modified open door laminoplasty has advantage to maintain open-window in comparison with classical open-door laminoplasty.