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Journal of Clinical and Translational Research 2024; 10(1): 1-8
Journal of Clinical and Translational Research
Journal homepage: http://www.jctres.com/en/home
ORIGINAL ARTICLE
Comparison of laminoplasty and posterior segment fusion with
laminoplasty and anterior segment fusion for treating acute extensional
cervical spinal cord injury in pre-existing canal stenosis: a multicenter
retrospective study
Hao Lv , Xuan Zou , Jiachao Xiong , Zhenhai Zhou , Junlong Zhong , Shengbiao Ma , WenbingWan , Bi Zhang ,
1†
1†
2†
1
1
3
1
4
Jiaquan Luo , Qiang Xiao , Kai Cao 1
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6
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1 Orthopedic Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China, Department
of Orthopedic Surgery, The Second Hospital of Jingdezhen City, Jingdezhen City, Jiangxi Province, China, Department of Orthopedic Surgery, The
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Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China, Department of Orthopedic Surgery, The Affiliated Ganzhou
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Hospital of Nanchang University, Ganzhou, Jiangxi Province, China, Department of Orthopedic Surgery, The First Affiliated Hospital of Gannan
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Medical College, Ganzhou, Jiangxi Province, China, Department of Orthopedic Surgery, The People‘s Hospital of Jiangxi Province, Nanchang,
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Jiangxi Province, China
ARTICLE INFO ABSTRACT
Article history: Background: Patients with pre-existing cervical spinal canal stenosis (CSCS) are more likely to
Received: February 19, 2023 suffer from an extensional spinal cord injury (SCI). However, the appropriate surgical alternatives for
Accepted: December 19, 2023 extended cervical SCIs in individuals with pre-existing CSCS remain unknown. The purpose of this
Published online: February 1, 2023 study was to evaluate the clinical efficacies of laminoplasty and posterior short-segment fusion (PSF)
with laminoplasty and anterior short-segment fusion (ASF) in the treatment of these patients.
Keywords: Methods: The clinical data of 258 patients from six spine centers were included in this retrospective
Extensional cervical spinal cord injury study. Patients were divided into two different groups based on the surgical approach: laminoplasty
Cervical spinal canal stenosis and PSF (PSF group) and laminoplasty and ASF (ASF group). ASIA grades and JOA scores were
Laminoplasty obtained before and after surgery to assess neurological function.
Posterior short-segment fusion Results: There were 116 patients in the PSF group and 142 patients in the ASF group. The average
Anterior cervical discectomy and fusion operation time, intraoperative blood loss, and hospital stay were 188 min, 298 ml, and 7.6 days,
Clinical efficacy respectively, in PSF group, compared to 245 min, 366 ml, and 10.4 days in PSF group, respectively.
Complete decompression was achieved in all patients, and fusion was achieved 6 months after surgery.
*Corresponding author: A post-operative computed tomography scan revealed that 39/464 (8.4%) screws had perforated, but
Kai Cao no neurovascular complications occurred. Both surgical strategies improved the ASIA grade and there
Orthopedic Hospital, The First Affiliated was no significant difference between the two groups (P = 0.926). The JOA score improved from 6.21
Hospital of Nanchang University, Nanchang ± 1.85 to 10.90 ± 3.56 in the PSF group and from 6.45 ± 2.17 to 11.48 ± 3.62 in the ASF group, but
(330209), Jiangxi Province, China. at the final follow-up, there was no significant difference between the two groups (P = 0.134). The
Email: kaichaw@126.com incidence of post-operative complications in the ASF group (24/142, 16.9%) (P = 0.043) was higher
than that in the PSF group (6/116, 5.17%).
© 2024 Author(s). This is an Open-Access Conclusions: Cervical laminoplasty combined with short-segment transpedicular screw fixation
article distributed under the terms of the is a reliable option to treat extensional cervical SCIs in patients with CSCS. This surgical strategy
Creative Commons Attribution-Noncommercial is beneficial for achieving sufficient cervical spinal cord decompression, preserving cervical spine
License, permitting all non-commercial use,
distribution, and reproduction in any medium, stability, and avoiding extra anterior cervical decompression and fusion, thereby reducing surgery
provided the original work is properly cited. time, intraoperative blood loss volume, post-operative complication rate, and length of hospital stay.
Relevance for Patients: Cervical laminoplasty combined with posterior segmental fusion (PSF)
reduces operative time, bleeding, and complications and achieves adequate spinal cord decompression
in the treatment of extension cervical SCI in patients with CSCS.
DOI: https://doi.org/10.36922/jctr.00037
