The analysis of effects and complications of cervical spondylotic myelopathy(CSM)treated with de compression by two different approaches / 中华骨科杂志

ABSTRACT

Objective To analyze functional improvement of spinal cord and the prognosis of two surgical approaches for the stenosis of cervical spinal canal;to investigate the mechanisms concerning post-terior decompression,fusion with ilium graft and internal fixation and 158 cases who underwent dorsal laminectomy from January 2001 to October 2002 were follow-up for at least 24 months and examined with the evaluation systems of Japanese Orthopaedic Association Score,somatosensary evoked essential and initiative range of motion to compare preoperative,short-term and long-term efficacy.Results According to selected standard of improvement rate,therapeutic effect of 56 sufferers among ventral approach group was analyzed,14 cases(25%)excellent,29 cases(51.79%)good,10 cases(17.86%)fair,3 cases(5.36%)poor;postoperative effect of 62 sufferers from dorsal approach group was analyzed,23 cases(37.10%)excellent,31 cases(50%)good,7 cases(11.29%)fair,1 case(1.61%)poor.Concerning JOA evaluation of spinal cord function,initiative range of motion and correlated parameters of SEP,there was significant difference between two decompression approach in postoperative periods.7 cases from anterior approach and 13 patients from posterior approach disturbed by postoperative complications were gradually rehabilitated through conservative of Cervical 5 spinal root',the essence of above-mentioned symptoms may be cervical cord impairment due to decompression process,which would be alleviated by appropriate intervention;2)The efficiency of posterior decompression get the better of anterior decompression in light of fundamentally enlarging available space approach became a little smaller than normal individuals,however,the corresponding parameters after anterior approach lower than the former two groups.