Effect of different fixation methods on cervical curvature and axial symptoms in posterior cervical single?door surgery / 中国综合临床

ABSTRACT

Objective To observe the effect of different fixation methods on cervical curvature and axial symptoms in posterior cervical single?door surgery??Methods From September 2014 to February 2016, 112 patients with multi?segment cervical spondylotic myelopathy underwent surgical treatment in Handan Central Hospital of Hebei Province??According to the lamina fixation methods,they were divided into groups A,B and C??There were 35 cases in group A,using suture suspension method to fix lamina; 34 cases in group B,using anchor suspension to fix lamina;and 43 cases in group C,using mini?titanium plate to fix lamina The operation time,intraoperative blood loss,laminae open angle,spinal drift distance,postoperative neurological recovery,cervical curvature index ( CCI ) and occurrence of axonal symptoms were compared in each group??Results All patients underwent surgery successfully??There were no significant differences in operation time,intraoperative blood loss,laminae open angle and spinal drift distance between the 3 groups (all P＞0??05)??The JOA score of group A was (7??9± 2??2) preoperatively,(9??3± 2??8) at 3 months after surgery,and (13??9±3??4) at the final follow?up??In Group B was (7??7±2??0) preoperatively,(9??1±2??7) at 3 months after surgery,and (13??6±3??7) at the final follow?up??In Group C was (7??8±2??1),( 9??0±2??6) and (13??8 ± 3??5 ), respectively, there were significant differences before and after operation ( Fintra?grouP＝7??271, Pintra?grouP ＜ 0??001; Finter?grouP ＝ 11??372, Pinter?grouP ＜ 0??001; Finteraction ＝ 9??831, Pinteraction＜0??001)??The CCI of group A was ( 22??7± 5??6)% preoperatively,(20??5± 4??4)% at 3 months after surgery,and (16??6± 3??0)% at the final follow?up??The CCI of group B was ( 21??4 ± 5??2)%,( 19??7 ±4??1)% and (17??8±2??9)% respectively??The CCI of group C was ( 21??1 ± 5??0)%,( 20??8 ± 4??6)% and (19??8 ± 4??0)% respectively??There were significant differences between group A and group B in the last follow?up and the three months before and after operation??( all P＜0??05),there was no significant difference between groups C at different time points ( P＞0??05)??According to the visual analogue scoring system,the distribution of axial symptoms in group C was significantly better than that in group A and group B ( Z＝6??678;P＝0??035)??Conclusion Posterior single?door mini?titanium plate fixation can not only improve nerve function,but also prevent cervical curvature loss and reduce the occurrence of axonal symptoms??