| Purpose:To explore the short-term clinical effect of one-stage anterior and posterior combined surgery in the treatment of clamp-on cervical spondylotic myelopathyMethod:A collection of 28 patients with clamp-type cervical spondylotic myelopathy who were diagnosed in the Second Affiliated Hospital of Nanchang University from November 2016 to December 2019 and selected one-stage posterior and anterior surgical treatment.The number of males is 19,and the others 9 are females,Age stage is 33-74 years old,with an average of 58.1 years old.Among them,there were basic diseases: The number of people with hypertension is 8,with COPD is 1,with diabetes is 10,all of which were treated with drugs and related treatments and surgery after conformity.The one-stage anterior and posterior approach is divided into two parts;First of all,the posterior cervical single-door spinal canal enlargement Or laminectomy was performed,and then anterior cervical discectomy,bone graft,fusion and internal fixation was performed.Follow-up of surgical patients,Make a statistics of operation time,surgical bleeding,total drainage volume of incision 48 h after operation,hospital stay and perioperative complications status,Make a statistics of index data such as JOA score,VAS score and neurological function improvement rate before surgery,1 day,3 months,6 months,12 months after surgery and the ending follow-up,and compare and analyze the data.Result:Everyone patients were completed the anterior and posterior surgery in one stage successfully.The average surgical time was 212.8±37.5min,the surgical bleeding loss was 210.0±33.7ml,The total drainage volume after 24 h was180.2±50.3ml,and The average length of hospital stay was 13.7±2.1d.The follow-up time was Up12 to 24 months,with an average of 19.2 months.Clinical efficacy: JOA score preoperative,3 months、6 months、12 months and the last time average score respectively after operation were 6.8±1.3;10.5±0.9;12.1±1.5;12.7±0.2;13.8±0.2;14.5±1.2;The average scores of VAS were before surgery(7.8±1.3),1 day after surgery(5.1±0.8),3 months after surgery(4.1±0.6),6 months after surgery(3.4±0.7),12 months after surgery(2.8±0.8),and the last average respectively(1.9±0.7);The JOA scores and VAS scores of all patients in each follow-up period after surgery were significantly different from those before surgery(P < 0.05),The neurological improvement rate scores were 40.7±4.3;45.7±10.4;53.6±10.5;66.8±7.8;79.6±7.4respectively at 1 day 、3 months、6 months、12 months after surgery and last time.Conclusion:The clinical symptoms and subjective feelings of 28 patients were improved to varying degrees.The first-stage cervical anterior and posterior surgical treatment of clamp-type cervical spondylotic myelopathy is adequately decompressed and fixed firmly.Not only the symptoms of spinal cord compression are fully alleviated,but the number of days in hospital of the patient’s is greatly shortened.The clinical effect is good and it is an effective surgical procedure.,So it is worth implementing. |
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