{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T13:50:23Z","timestamp":1775137823038,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T00:00:00Z","timestamp":1640563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81672200"],"award-info":[{"award-number":["81672200"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81871804"],"award-info":[{"award-number":["81871804"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the surgical technique of cervical transdural discectomy with laminoplasty (CTDL) for the treatment of multi\u2010segment cervical spinal stenosis (CSS) accompanied with cervical disc herniation (CDH) and investigate its surgical outcomes and complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a clinical study. Between 2012 and 2018, 31 patients (13 males and 18 females) with multi\u2010segment CSS (over two cervical segments) accompanied with huge CDH and underwent CTDL were enrolled in this study. The details of CTDL technique with general anesthesia was described by the authors. The average follow\u2010up period of patients was 65.03\u00a0months (range from 24 to 126\u00a0months). Perioperative parameters such as age, sex, operative level, operative time, estimated blood loss, ambulation time, and operative complications were recorded. The results of clinical metrics such as the visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) scores in the preoperative and during the follow\u2010up period were obtained and used to evaluate clinical outcomes. Radiographic improvement was evaluated by the compression ratio, sagittal maximum spinal cord compression (SMSCC), and cervical range of motion (ROM). The preoperative and postoperative follow\u2010up parameters (VAS, JOA, Compression ratio, SMSCC, and ROM) were assessed with paired <jats:italic>t<\/jats:italic> test. A <jats:italic>P<\/jats:italic>\u2010value &lt;0.05 was considered statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the study, the mean age of the 31 patients was 55.23\u2009\u00b1\u200910.97\u2009years. The mean operative time was 192.45\u2009\u00b1\u200924.17\u00a0min (ranging from 150 to 245\u00a0min), and intraoperative blood loss was 322.58\u2009\u00b1\u2009129.00\u2009mL (ranging from 150 to 600\u2009mL). The VAS neck pain was improved significantly over the follow\u2010up period (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05, respectively). The VAS arm pain improved significantly from 6.26\u2009\u00b1\u20090.93 preoperatively to 1.74\u2009\u00b1\u20090.63 at 24\u00a0months postoperatively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). There was no significant difference in improvement of VAS arm pain between 24\u00a0months postoperatively and final follow\u2010up (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.180). Compared with preoperative JOA score, JOA score was significantly improved at 24\u00a0months postoperatively (14.79\u2009\u00b1\u20091.84 <jats:italic>vs<\/jats:italic> 9.66\u2009\u00b1\u20092.81, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Meanwhile, there were no statistically significant differences between the final follow\u2010up and the postoperative JOA scores (15.08\u2009\u00b1\u20091.71 <jats:italic>vs<\/jats:italic> 14.79\u2009\u00b1\u20091.84, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.051). Postoperative patients showed significantly higher index of compression ratio (58.30\u2009\u00b1\u20098.51 <jats:italic>vs<\/jats:italic> 27.17\u2009\u00b1\u20093.89, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and lower SMSCC (25.12\u2009\u00b1\u20095.67 <jats:italic>vs<\/jats:italic> 33.66\u2009\u00b1\u20095.38, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). In addition, there was no significant difference between preoperative and postoperative cervical ROM (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.740). One patient observed postoperative symptom of C<jats:sub>6<\/jats:sub> nerve root injury, which was resolved within 24\u00a0months after the surgery; meanwhile, the neurological monitoring also reflected the intraoperative stretching of the C<jats:sub>6<\/jats:sub> nerve root. Two cases involved postoperative cerebrospinal fluid (CSF) leakage which may have been related to laceration of dura mater.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study suggested that CTDL technique could acquire satisfactory surgical outcomes for patients with multi\u2010segment CSS accompanied with CDH, but the surgical indications of the patients need to be selected strictly.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13189","type":"journal-article","created":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T09:25:00Z","timestamp":1640597100000},"page":"356-364","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cervical Transdural Discectomy with Laminoplasty for the Treatment of Multi\u2010segment Cervical Spinal Stenosis Accompanied with Cervical Disc Herniation: Technical Note and Clinical Outcome"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1974-1311","authenticated-orcid":false,"given":"Hao","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Spinal Surgery The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruixiang","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Pain YanTai YuHuangDing Hospital  Yantai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guanghui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery The Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic The Gaomi People's Hospital  Gaomi 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