Comparison of the Therapeutic Characteristics of Anterior Hybrid Decompression and Posterior Decompression in the treatment of Multilevel Cervical Spondylotic Myelopathy / 现代生物医学进展

ABSTRACT

Objective:To compare the therapeutic characteristics of anterior hybrid decompression and posterior cervical posterior laminectomy in the treatment of multilevel cervical spondylotic myelopathy.Methods:Thirty six cases of multilevel cervical spondylotic myelopathy patients treated by anterior hybrid decompression and thirty three cases of multilevel cervical spondylotic myelopathy patients treated by posterior cervical posterior laminectomy were involved.The general information,bleeding amount,operative time,cervical curvature D value,JOA score and incidence of postoperative complications of the two groups before and after surgery were compared.Results:There was no significant difference in the general information among the two groups(P＞0.05),including age (anterior group56.23± 7.64 years old,posterior group55.76± 8.18 years old),sex (anterior group22 males/14 females,posterior group20 males/13 females),cervical curvature D value (anterior group7.41± 3.14,posterior group8.19± 2.74),JOA score (anterior group9.08± 1.09 scores,posterior group8.82± 1.26 scores),disease course (anterior group17.24± 7.36 months,posterior group15.75± 5.78 months) and affected segment (anterior group3.11 ± 0.26 segments,posterior group3.24± 0.39 segments).The the amount of bleeding in the anterior group (anterior approach:221.79± 178.02 ml,posterior group483.07± 434.25 ml) was lower than that of the posterior group(P＜0.05).The operative time (anterior group196.54± 51.88 mins,posterior group175.12± 54.93 mins) was longer,but there was no significant difference (P＞0.05).The cervical curvature D value and JOA score of posterior group were increased with the extension of surgery time.However,the cervical curvature D value of posterior group was decreased,but JOA score was increased.The incidence of bone unfinished,hoarseness and cerebrospinal fluid leakage were found in the anterior group,and axial pain and C5 nerve root paralysis were found in the posterior group.But there was no significant difference in the incidence of complications between the two groups (anterior group 14.89％,posterior group12.12％)(P＞0.05).Conclusions:Anterior hybrid decompression and posterior cervical posterior laminectomy had their own advantages in the treatment of multilevel cervical spondylotic myelopathy.,The appropriate treatment should be taken according to the condition of patients.