The Comparation And Analysis Of Axial Symptoms After Surgery Through The I-stage Combination Operation Of Anterior And Posterior Approaches And Posterior Approaches

Objective：By comparing with the pure cervical posterior single door vertebral canalexpanded keratoplasty, the paper aims to explore the incidence of axial symptoms andclinical significance specific to patients who are treated by the increased anteriorfusion cage or Vertebral body whole cutting pressure-relief titanium mesh fusion forthe treatment of cervical spondylosis.Methods：This study retrospectively analyzed the patients of Spinal orthopaedic of the firstaffiliated hospital of zheng zhou university in nearly four years (from October2011toJanuary2014), who was cured by the methods above-mentioned.The author has donefollow up visits by reexamination of outpatient service, and chosen fifty cases into thestudy, who meet the criterion and have complete data. There are22cases in group A,who have been cured with the I-stage combination operation of anterior and posteriorapproaches. There28cases in group B, who have been cured with the posteriorapproaches. After3-48months’ follow up visit, the author has made a contrastbetween these two goups on the function improvement,occurrence rate of axial symptoms and cervical curvature index.1The axial symptomsAccording to the patients described and combining general classificationmethods, we use the literature classification of four points: excellent, withoutpostoperative neck symptoms; Good, symptoms in overworked or catch cold,symptom is lighter, the impact on the life and work is slight,and rest or decubitus canease the sympyom, do not need to take the analgesic drugs; General, symptoms occurmore frequently, but no more than three months each year,with neck tendernessspasm taking painkillers to alleviate; Poor, symptoms appear very frequent, more thanthree months,with serious stiff neck pain and numb,but painkiller not work.2Neurologic evaluationNeurologic evaluation method of using the Japanese orthopaedic associationJOA17points, out of17points (including upper and lower limb motor function allfour points, and function of lower limbs and somatosensory each2points, bladderfunction3points), completely abnormal0. Four levels: ill (0~4points): most orcomplete paralysis of limbs, the life cannot provide for oneself; Severe (5~8points):some functions of limbs, but the loss of working ability; Moderate (9~12points):motor and sensory disorder exists, but it can do some simple work; Mild (13~16points): mild motor and sensory disorder, can basically meet the need of work andlife. Calculate the period at the same time, the period (rate of the improved JOA scoreand RIS)=[(postoperative scores-preoperative scores)/(17-preoperative score)] x100%; RIS acuity75%,50%~50%,25%~50%,<25%were poor. Comparison oftwo groups of patients with preoperative and postoperative JOA score differences.3Imagination measurementsImagination measurements were taken at the time of50patients before surgeryand follow-up lateral cervical neutral slice., when the CCI is measured by reference toIshihara’s method, namely in postoperative patients with preoperative X-ray C2~6vertebral rear attachment, measuring the length of D, C3~5vertebral trailing edge to the vertical distance D for d1, d2, d3, cervical curvature index calculated by thefollowing formula: CCI di/D=2) intervertebral glide scope Tanaka method tomeasure the upper edge of the vertebral bodies e do lower vertebral rear attachment Fparallel calculation of the distance between two parallel c=c1+C2, QuQuWei e c1before the F line positive instead of negative. After with a point on the line e C2forpositive, negative. Compare the preoperative and postoperative c value changes.4Statistical analysisUsing SPSS18.0software, according to different observation index and data, thestatistical processing. Measurement data results expressed in standard deviation usingt test; Skewness distribution data using nonparametric tests (Wilcoxon test or theMann-Whitney U test). Count data using X2test; Level data with rank andinspection. Inspection level of P <0.05for the difference was statistically significant.Result：There is no obvious difference on the recovery of the nerve function. However,compared with group B, the incidence of axial symptoms and cervical spine curvatureindex of the patents in group A have relatively significant improvement.Conclusion：Compared with the posterior approaches,the I-stage combination operation ofanterior and posterior approaches can decrease the incidence of axial symptoms andmaintain cervical physiological curvature of patients so that the balance of verticalplane can be maintained, and it is also of great importance to maintain the long-termstability of cervical spine after the operation.