简介:
简介:Objective:Tostudythefeasibilityofmulti-slicespiralcomputedtomography(MSCT)3-dimensionalreconstruc-tiontechniqueinassistingcervicalpediclescrewfixation(PSF)anddouble-doorlaminoplastytotreatmulti-segmen-taldegenerativespinalstenosiswithtraumaticinstability(MDSTI)oflowercervicalspine.Methods:FromSeptember2006toAugust2007,PSFcombinedwithdouble-doorlaminoplastywasperformedin9patientswithMDSTIoflowercervicalspine.MSCT3-dimensionalreconstructiontechniques,includingvolumerendering(VR)andmulti-planarreconstruction(MPR),wereusedtoassistpreoperativediagnosisandmeasurementtoguidetheprocedure.MPRwasperformedafteroperation.Incoronalview,thedegreeofscrewperforationwasmea-suredpreciselyandthedifferentpositionsofpediclescrewsweredividedintothreegradesaccordingtoRichter'smethod.Inaxialview,thecanalsagittaldiameterandtrans-verseareaofeverylaminoplastylevelweremeasured.Results:NinepatientswithMDSTIoflowercervicalspineunderwentPSF(total44screws).AccordingtotheclassificationofRichter,72.7%(32/44)wasinGrade1and27.3%(12/44)wasinGrade2.NoscrewperforationoccurredinGrade3andnoscrewrevisionwasdoneformisplacement.Noiatrogenicdamagewasobserved.Double-doorlaminoplastywasperformedintotal42volumes.Thepost-operativesagittaldiameterandtransverseareaofcervicalspinalcanalweresignificantlyincreased(P<0.05).Theconfi-denceintervalsofmeanincreasedratiowere23.43%-40.65%insagittaldiameterand23.18%-42.07%intransversearea.Sixmonthsafterlaminoplasty,basedonMSCTaxialview,completeunionbetween"opendoor"andallograftbonewasobtainedin76.19%ofvolumes(32/42),andallograftbonewasabsorbedpartlyin23.81%(10/42).Asolidunioninbilateralgutterswasachievedinallcases.Theywerefollowedupfrom6monthsto1year(mean7.8months).Post-operativeneuralfunctionrecoveryintwocasesimproved2ASIAgrade,5casesi