An analysis of the operative methods and effects of I stage decompression in the treatment of cervical spine stenosis with lumbar spinal canal stenosis

YU Ling; SUN Xiang-ran; HU Qing-zhu; GUO Wei-chun

doi:10.3969/j.issn.2095-252X.2018.06.003

Abstract：Objective To explore the therapeutic effects and surgical methods of I stage decompression in the treatment of cervical spinal stenosis complicated with lumbar spinal stenosis. Methods The clinical data of 72 patients with multi-segmental spinal stenosis, treated surgically in our hospital from January 2012 to January 2016, were retrospectively analyzed. According to the surgical methods, all patients were divided into 2 groups: Group A, n = 32, stage I decompression of the cervical and lumbar spine; Group B, n = 40, traditional staged surgery. The operation time, intraoperative blood loss, bedtime, hospitalization time, Japanese Orthopaedic Association ( JOA ), visual analog scale ( VAS ) were compared between the 2 groups. Results The amount of blood loss and operation time in Group A were greater and longer than those in Group B with statistical significance ( P < 0.05 ). There were no significant differences in the time of getting out of bed between the 2 groups ( P > 0.05 ). The total length of stay in Group A was shorter than that in Group B with statistical significance ( P < 0.05 ). At 1 month, 6 months, and the latest follow-up, the mean JOA scores ( upper extremity motor function, lower extremity motor function, sensory function, bladder function ) in Group A were higher than those in Group B with statistical significance ( P < 0.05 ). At 2, 8, 12 and 24 hours after operation, the VAS scores in Group A were higher than those in Group B with statistical significance ( P < 0.05 ). The complication rate in Group A and Group B were 18.75% and 32.50% with no statistical significance between the 2 groups ( P > 0.05 ). Conclusions I stage decompression has longer operation time and more bleeding than traditional staged surgery in the treatment of cervical spinal stenosis combined with lumbar spinal stenosis. However, postoperative spinal nerve functions are better, and hospital stay is shorter.