Influence of three cervical posterior surgical methods on physiological curvature of multi-segmental cervical spondylosis myelopathy and their long-term effects

GOU Bo; SU Quan

doi:10.3969/j.issn.2095-3402.2018.01.009

Abstract：Objective To observe the influence of three cervical posterior surgical methods on the physiological curvature of multi-segmental cervical spondylosis myelopathy and their long-term effects. Methods One hundred and twenty-six cases of patients with multi-segmental cervical spondylosis myelopathy treated in our hospital between January 2012 and June 2016 were selected as subjects, who were divided into the expansive open-door laminoplastyby cervical posterior approach group(Group A)44 people, laminectomyby cervical posterior approach group(Group B)39 people and laminectomy and lateral mass screw fixationby cervical posterior approach group(Group C)43 people according to different surgical methods. All the patients were followed up for 12 months. The recovery of neurological function and axial symptoms before operation and 3, 12 months after operation were observed, while the cervical flexure angle and intervertebral height before operation and 3, 12 months after operation were detected. Results The scores of Japanese orthopedic association(JOA) and visual analogue scale(VAS) in the three groups 3 and 12 months after operation were higher than those before operation(P<0.05). 12 months after operation, the scores of JOA in Group A and Group C were higher than those in Group B, the scores of VAS in Group A and Group C were lower than those of Group B(P<0.05), but there was no significant difference between Group A and Group C(P>0.05). 12 months after operation, the excellence rate of neurological function in Group A and Group C was higher than that of Group B(P<0.05). 3 months after operation, the cervical flexure angle in the three groups was significantly different(P<0.05). 12 months after operation, Group C was significantly different from Group A and Group B(P<0.05). Conclusions The three cervical posterior surgical methods for multi-segmental cervical spondylosis myelopathy have better short-term effects. However, in terms of long-term effects, the improvement of expansive open-door laminoplasty by cervical posterior approach and laminectomy and lateral mass screw fixation by cervical posterior approach for postoperative neurological function and axial symptoms is better than that of laminectomy by cervical posterior approach. Laminectomy and lateral mass screw fixation by cervical posterior approach can more effectively recover the cervical flexure angle and intervertebral height than the other surgical methods, which is a reliable surgical method for the decompression and fixation of cervical posterior approach.