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OBJECTIVE@#To study the correlation and clinical value of the arc height of upper and lower endplates, the height of intervertebral space and osteophyte of posterior edge of intervertebral space in patients with cervical spondylosis.@*METHODS@#A total of 108 patients with cervical spondylosis who underwent cervical spondylosis surgery from September 2017 to September 2018 were included in the study. Including 48 males with an average age of 52 years (30 to 72) and 60 females with an average age of 54 years (37 to 79). Among them, C of 6 cases, C of 15 cases, C of 32 cases, C of 42 cases, C of 13 cases. X-ray films of cervical spine were taken before and after operation. The images were accessed by PACS (Picture Archiving and Communication Systems) system. The lower and upper endplate arc heights (L, L), intervertebral space height (L), and posterior osteophyte width (L) were measured. Spearman was used to analyze the correlation between them.@*RESULTS@#L was negatively correlated with L (r=-0.34, 0.05), L and L (>0.05).@*CONCLUSION@#The arc height of the lower endplate is negatively correlated with the width of osteophyte in the posterior margin of the intervertebral space. The cervical degeneration degree can be determined by measuring the arc height of the lower endplate, which has guiding significance for the early prevention and treatment of cervical spondylosis.
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Objective To evaluate the clinical and radiological factors which affecting the recovery duration of C5 palsy after cervical decompression surgery.Methods The datas of 710 patients with degenerative cervical spine surgery in departement of spine surgery of orthopaedics of general hospital of Shenyang military region were retrospectively analyzed.The demographics,radiology,clinical information were recorded to analyze the relationship with the recovery duration of postoperative C5 palsy.Results C5 nerve root palsy occurred in 36 cases,of which 33 cases completely recovered within 2 years after surgery(18 cases recovered within postoperative 6 months),3 cases did not completely recovered during the following period.Factors related to longer recovery(over 6 months) included postoperative limbs muscles strength ≤2(P＜0.01),presence of multi-segment paresis involving more than the C5 root(P =0.002),loss of somatic sensation with pain(P =0.008),and the degree of posterior spinal cord shifting (P =0.040).Furthermore,multivariate analysis revealed that postoperative limbs muscles strength ≤2(P =0.010) had a significant effect on a recovery duration beyond 6 months.Conclusion The postoperative limbs muscles strength ≤2,the presence of multi-segment paresis involving more than the C5 root,the loss of somatic sensation with pain,and the degree of posterior spinal cord shifting are main factors which significantly influence the duration of recovery from postoperative C5 nerve root palsy.
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Objective To analyze the clinical value of anterior decompression and fusion with internal fixation and simple decompression in the treatment of cervical vertebral multilevel degeneration.Methods Selected 40 patients with cervical degenerative changes in our hospital from 2012 to 2014,and 20 patients of them underwent anterior decompression and fusion with internal fixation while the other 20 cases took simple decompression.All the patients were well followed up,and the clinical therapeutic effect of the two groups were compared and analyzed.Results After operation,the VAS score and JOA score showed that the scores of the patients underwent anterior decompression and fusion with internal fixation were significandy improved compared with the simple decompression group,and the difference was statistically significant(P ＜ 0.05).Compared with the simple decompression group,the cervical curvature and the curvature of the surgerysection in the anterior decompression and fusion with internal fixation group were significantly improved,especially in the first year after surgery (P ＜ 0.05).The cervical spine joint activity of the two group were improved in the first year after surgery,and the difference was significant (P ＜ 0.05),but there was no significant difference in the degree of cervical joint activity at the last follow-up(P ＞ 0.05).The anterior decompression and fusion with internal fixation is better than simple decompression in the degree of cervical joint activity with statistical significance (P ＜ 0.05).Conclusion The clinical effect of anterior decompression and fusion with internal fixation in treatment of multiple segment degeneration of cervical spine is better than that of simple decompression,it can meet the clinical requirements of biomechanics.
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OBJECTIVES: Anterior microforaminotomy (AMF) is an alternative procedure to treat unilateral cervical pathology. Although the results have been reported favorable in the previous studies, postoperative degeneration may occur. We analyze long-term outcome to determine the critical size of AMF. METHODS: A retrospective study was performed. Clinical data with chart review, radiologic data with picture archiving and communication system (PACS) images were obtained. Long-term clinical outcomes were accessed by a questionnaire, including visual analogue scale (VAS) and neck disability index (NDI). Various clinical, radiological data were statistically analyzed. RESULTS: Eight-two patients were enrolled in this study. Main pathology was spondylotic spur (53.7%), soft disc herniation (36%). Mean age was 49 years old. There was no surgery-related complication. Mean follow-up was 6.1 years. 90.3% showed favorable clinical outcome. Mean VAS score was decreased from 8.2 to 2.9, and NDI score was decreased from 24.5 to 6.7 (P<0.05). 88.7% showed decrease of disc height (DH), and mean change was 1 mm. DH change was correlated positively with the disc invasion and AMF diameter (P<0.05). Mean diameter of AMF was 5.2 mm. According to statistical analysis, the critical diameter of AMF was 4.7 mm, directly affecting DH decrease. Any radiological parameters did not affect the clinical outcome. CONCLUSION: AMF was an effective procedure to treat unilateral cervical pathology. Critical DH decreases and/or disc invasion may be the trigger of sequential degeneration. To preserve DH, AMF diameter should be small and disc invasion should be avoided.