Analysis on the effect of different surgical methods on patients with severe cervical spondylotic myelopathy / 中国综合临床

ABSTRACT

Objective To compare the causes of poor effects after surgical treatment for severe cervical spondylotic myelopathy,and to analyze the clinical value of posterior surgery in the treatment of severe cervical spondylotic myelopathy.Methods From September 2013 to November 2016,ninety-two patients with severe cervical myelopathy in Shiyan Medical Hospital were selected as the research object,the patients were divided into the observation group and the control group,50 cases in each group,according to the different surgical methods,the control group received anterior cervical discectomy and interbody fusion and internal fixation treatment,the observation group was treated with cervical posterior decompression surgical treatment,the prognosis and the changes of cervical vertebra function in the two groups were recorded.Results There were statistically significant differences between the two groups in terms of operation time,intraoperative blood loss and postoperative hospital stay(t=5.392,7.114,4.552,P<0.05).The intervertebral height at 1 month after surgery in the observation group and the control group were(4.92 ± 1.51)mm and(4.26 ± 1.32)mm,significantly lower than those before the operation((3.72±0.42)mm,(3.78±0.93)mm)(t=10.495,6.114,P<0.05) .At 1 month after operation,the intervertebral height of the observation group was significantly higher than that of the control group(t=4.521,P<0.05).The excellent and good rate of JOA score of the observation group and control group at 1 month after operation were 97.6% and 84.0%,respectively,and the rate of the observation group was significantly higher than that of the control group(χ2=4.797,P<0.05).In the observation group and the control group,there were 1 case of throat pain after operation,and they were relieved after suitable treatment.Conclusion Compared with the anterior approach,the posterior treatment of severe cervical spondylotic myelopathy can reduce the trauma of patients,promote the recovery of intervertebral height and improve the function of the cervical spine,so as to achieve better results.