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Objective To investigate the prognosis of two decompression approaches for cervical spondylotic myelopathy. Methods 86 cases were divided into two groups. 40 cases were underwent decompression by anterior decompression, fusion and internal fixation with titanium screws and plate and 46 cases underwent posterior single opendoor laminoplasty. To investigate the prognosis of two decompression approaches for single compressive segment, two compressive segments, three compressive segments and four compressive segments. Results All cases were followed up for 20 ~ 73 months with an average of 43 months. The mean JOA recovery rate was significant different between single compressive segment group (P < 0.05), and no significant difference between two compressive segments and three compressive segments(P > 0.05), and significant difference between four compressive segments groups (P <0.05). Conclusion For single compressive segment, the anterior surgery has a good surgical result,for two or three compressive segments, anterior and posterior surgery had same effect, for the four compressive segments, posterior surgical effect was good.
RESUMO
[Objective]To investigate the surgical method and clinical effects of the anterior approach operation in the treatment of thoraco-lumbar vertebral fractures through limited incision.[Method]Thirty-four cases of bursting fracture of thoracolumbar vertebral body were treated with the operation of anterior decompression,bone grafting and internal fixation by the anterior retropleuro-peritoneum approach.The MRI combined with clinical examination,X-ray,CT results were taken as selection criteria of treatment.[Result]Thirty-four cases were treated with this operative technich.Hemorrhage capacity is about 300-800ml with average 600ml.The operation time was 2-2.5 hours.All patients were followed-up with an average period of 18 months(ranged,6-24months).No aggravation of nerve injury appeared in 34 cases.X-ray manifested good fusion,no broken nails and no recurrence of kyphosis was found in all cases.[Conclusion]Anterior approach operation through limited incision is an effective way for severe thoracolumbar fractures. It has significantly low complication and allow early recovery of function.