A Study on the Volume Changes of the Posterior Cervical Paravertebral Muscles After Unilateral Exposure Channel-Assisted Laminoplasty.

Abstract

Study DesignRetrospective Cohort Study.ObjectiveThe aim of this study was to evaluate the efficacy of our proposed surgical procedure named unilateral exposure channel-assisted (UCA) laminoplasty in treating degenerative cervical myelopathy (DCM), and the postoperative volume changes of cervical paraspinal muscles.MethodsFrom January 2020 to January 2022, 104 patients with DCM underwent unilateral open-door laminoplasty, among which, 63 patients underwent UCA laminoplasty (UCA group) and 41 patients underwent traditional laminoplasty (LP group). The radiological and clinical parameters as well as postoperative complications were recorded and analyzed before operation and during the follow-up.ResultsThe operation was completed successfully for all patients from both groups, who showed significant but comparable improvement in clinical outcome indicators including mJOA score, Neck pain VAS score, NDI score and radiological indicators including spinal canal diameter and area at the final follow-up compared to pre-operation. When conducting the intra-group comparison, less intraoperative time consumption and blood loss, less postoperative drainage and lower incidence of axial symptoms were observed in patients from UCA group than LP group. Furthermore, we found better preservation of C2-7 cobb angle, cervical curvature index (CCI) and cervical paraspinal muscle on the hinge side in patients underwent UCA laminoplasty than traditional laminoplasty.ConclusionThe UCA laminoplasty showed similar efficacy on alleviating clinical symptoms, and priority on maintaining cervical sagittal balance, minimizing intraoperative invasion, speeding up postoperative rehabilitation, reducing paraspinal muscle atrophy and postoperative axial symptoms when compared with traditional unilateral open-door laminoplasty.