Correlation Between Curvature Changes And Axial Symptoms Of Posterior Cervical Single Open-door Laminoplasty

Objective:To explore the relationship between cervical curvature changes and neurological function improvement,pain symptom relief and the incidence of axial symptoms after posterior cervical single open-door laminoplasty and the clinical significance.Methods:Between January 2011 and December 2015,55 patients with multilevel cervical spondylotic myelopathy(CSM)were underwent posterior cervical single open-door laminoplasty with two surgical methods.Group A(n=23)had underwent the traditional suture suspension fixation,which consist of 15 males and 8 females,with a mean age of57.1 years(range 42-75 years).Group B(n=32)had received the micro-titanium plate fixation,which consist of 21 males and 11 females,with a mean age of 56.6 years(range47-68 years).The recovery rate was calculated using pre-and postoperative JOA scores for each patient.The VAS scores was used to evaluate the recovery of pain before and after operation.The cervical curvature index was measured using cervical X-ray examination.The severity of the axial symptoms of the two groups was followed and the incidence rate was calculated.The above data were statistically analyzed.Results:Two groups of patients were followed up for 15 to 39 months,with an average of 18 months.The recovery rate of JOA score was(60.2 ±15.2)% in group A and(62.8 ±13.4)% in group B,There was no significant difference between the two groups.Thepain was relieved in both groups,the VAS score was(2.14±1.78)in group A and(2.55± 1.33)in group B,the difference was statistically significant.The loss of cervical curvature was(4.5±2.5)% in group A and(2.8±2.5)% in group B.The difference of cervical curvature before and after operation was statistically significant.The loss of cervical curvature in group A was significantly greater than that in group B.The proportion of patients with obvious axial symptoms was 39.13% in group A and 18.75%in group B.The difference between the two groups was statistically significant.Conclusion:1.For the treatment of multilevel cervical spondylotic myelopathy,the micro-titanium plate fixation method and the traditional suture suspension fixation method posterior cervical open-door laminoplasty both can get a good neurological improvement.2.Compared with the traditional suture suspension fixation method,micro-titanium plate fixation laminoplasty can reduce the loss of cervical curvature on the stability of the cervical spine.3.The loss of the cervical physiological curvature and the incidence of the axial symptoms have a certain correlation.To prevent the loss of cervical curvature can effectively prevent the occurrence of postoperative axial symptoms.