title: [Clinical application of lower cervical spinous process laminar screw technique in open door laminoplasty].
abstract: OBJECTIVE
  To investigate the clinical outcomes of lower cervical spinous process laminar screw technique in open door laminoplasty.
  
  
  METHODS
  From February 2005 to June 2010,12 patients with cervical myelopathy were treated with open door laminoplasty by lower cervical spinous process laminar screw technique. There was intervertebral disc herniation with degenerative stenosis in 5 patients, ossification of posterior longitudinal ligament with osteophyte in 6 patients, cervical traumatic instability with spinal cord injuries in 1 patient. Nerve function, complications, and the cervical canal to body ratio (CBR), range of motion (ROM) and the anteroposterior serial alignment were observed by Japanese Orthopedic Association (JOA) score, X-ray, CT and MRI.
  
  
  RESULTS
  The surgical time was from 1.5 to 2 h with an average of 110 min; blood loss during operation was from 450 to 800 ml with an average of 580 ml. Postoperative complication occurred in 1 case with upper limb pain and 1 case with cerebrospinal fluid leakage. All patients were followed up from 1 to 2 years with an average of 21.8 months. JOA score improved from preoperative 9.5 +/- 1.8 to postoperative 13.6 +/- 2.4 (P < 0.01). X-ray, CT, MRI showed CBR increased obviously (P < 0.01); ROM on flexion-extension and cervical lordosis decreased respectively from (40.0 +/- 10.0) degrees and (65.0 +/- 12.0)% before operation to (15.0 +/- 5.0) degrees and (42.0 +/- 8.0) % at the final follow-up (P < 0.01).
  
  
  CONCLUSIONS
  Lower cervical spinous process laminar screw technique in open door laminoplasty for cervical syndrome is safe and can obtain satisfactory effects, has strong internal fixation and reduce the risk of re-closure.
authors.affiliation: Department of Spinal Surgery, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China.
authors.forename: Hua-Jie
authors.initials: HJ
authors.lastname: Lin
authors.forename: Rong-Ming
authors.initials: RM
authors.lastname: Xu
authors.forename: Qi-Yun
authors.initials: QY
authors.lastname: Li
authors.forename: Guan-Yi
authors.initials: GY
authors.lastname: Liu
authors.forename: Wei-Hu
authors.initials: WH
authors.lastname: Ma
authors.forename: Shao-Hua
authors.initials: SH
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013130:Spinal Stenosis / Q000601:surgery*