The Efficacy Of C3 Laminectomy And C4-7 Single-door Vertebroplasty For Cervical Spinal Stenosis

PurPose:To explore the difference between the clinical efficacy and postoperative complications of modified single open laminoplasty(C3 laminectomy,C4-7 single open laminoplasty)and traditional C3-7 single open lam inoplasty,so as to provide certain reference for the surgical treatment of degenerative cervical spinal stenosis.Methods:75 patients who were admitted to our hospital from December 2017 to February 2019 for degenerative cervical stenosis with single open cervical surgery was retrospectively collected,excluding 7 patients with incomplete data,the remaining 68 patients were included in the study.Depending on the operation,they were divided into 33 cases(control group)who underwent traditional C3-7 single-door expansive laminoplasty and 35 cases(observation group)who underwent C3 laminectomy and C4-7 single-door expansive laminoplasty.There were 16 males and 17 females in the control group in which the age range was 46-69 years old,with an average age of(58.84±3.46)years old.The observation group included 17 males and 18 females which the age range was 48-70 years old with an average age of(59.71±3.35)years old.Adequate preoperative preparation and data evaluation were performed,the instruments and materials that were used in the operation are from the same manufacturer,and postoperative rehabilitatioe plans were used;the same recovery plan was used after surgery.The patients were followed up for at least 12 months.The general conditions of the patients before and after the operation were analyzed and compared.including the age,gender,course of disease,surgical incision length,operative time,intraoperative hemorrhage,length of hospitalization,hospital expenses and other general indicators,and the Japanese Orthopaedic Association score(JOA),cervical range of motion(ROM),C2-7 vertebral Cobb Angle,and the incidence of postoperative complications such as infection,reclosure,cerebrospinal fluid leakage,axial symptoms,and nerve root paralysis were compared between the two groups before,6 months and 12 months after surgery,to comprehensively evaluate the efficacy of the two surgical methods.Results:①There were no statistically significant differences in age,gender or course of disease between the two groups(P>0.05),and no significant differences in intraoperative incision length and length of hospital stay between the two groups(P>0.05).The control group was superior to the observation group in terms of duration of operation and intraoperative bleeding(P<0.05),but the cost of hospitalization was higher(P<0.05).②The JOA scores of the two groups at 6 months and 12 months after surgery were higher than those before surgery,but there was no significant difference in JOA scores between the two groups before and after surgery(P>0.05).③The cervical range of motion and C2-7 vertebral Cobb Angle 6 months and 12 months after surgery in both groups were lower than those before surgery,but the cervical range of motion and C2-7 vertebral Cobb Angle 6 months and 12 months after surgery in the control group were lower than those in the observation group(P<0.05).④There were no complications such as incision infection,cerebrospinal fluid leakage and redox closure in the two groups.There were 2 cases of nerve root paralysis in the control group and 1 case of nerve root paralysis in the observation group.The difference between the two groups was not statistically significant(P>0.05).However,the incidence of axial symptoms in the observation group was significantly lower than that in the control group,and the difference between the two groups was statistic ally significant(P<0.05)Conclusion:Compared with traditional posterior single-open laminectomy,C3 laminectomy and C4-7 open-door expansive laminoplasty not only can effectively relieve spinal nerve compression and improve nerve function,but also can better maintain cervical curvature,reduce cervical mobility loss and axial symptoms,and have certain clinical advantages.Therefore,it can be used as one of the commonly recommended surgical options for patients with multisegment cervical spinal stenosis.