Analysis of clinical effects of anterior segmental decompression for multi-segment cervical spondylotic myelopathy / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the clinical effects of anterior segmental decompression for the treatment of multi-segment cervical spondylotic myelopathy.</p><p><b>METHODS</b>The clinical data of 84 patients with multi-segment cervical spondylotic myelopathy treated between August 2005 to March 2016 were retrospectively analyzed. According to different operative methods the patients were divided into control group and observation group, with 42 cases in each group. In the control group, including 26 males and 16 females, the age was (56.87±11.89) years old and course of disease was(7.91±3.71) years on average, the lesion segment occurred on C₃-C₆ of 36 cases and on C₄-C₇ of 6 cases. There were 24 males and 18 females in observation group, with the mean age of (54.58±12.56) years old, and the course of disease was(8.03±3.52) years, the lesion segment occurred on C₃-C₆ of 34 cases, and on C₄-C₇ of 8 cases. The patients in control group were treated with posterior laminoplasty, and the patients in observation group underwent anterior segmental decompression. Operation time, intraoperative blood loss, hospitalization time, bone graft fusion time and complication rate were observed between two groups. JOA scores and Cobb angle of fusion segment were compared before operation and 3, 6, 9 months after operation.</p><p><b>RESULTS</b>Operation time, intraoperative blood loss, hospitalization time and complication rate in observation group were significantly lower than in control group(<0.05); the bone fusion time in observation group was significantly lower than in control group(<0.01);3, 6, 9 months after surgery, JOA score and the segment Cobb angle in observation group were significantly higher than in control group(<0.01).</p><p><b>CONCLUSIONS</b>Anterior segmental decompression for the treatment of multi-segment cervical spondylotic myelopathy has obvious advantages of less vertebral resection, thorough decompression, good stability, less postoperative complications, which can effectively promote the recovery of the spinal cord function and vertebral stability.</p>