Clinical Study Of Intraoperatine Ultrasound Real-time Evaluation Of Decompression Effect Of Posterior Single Door Laminoplasty

Objective To investigate the clinical significance of intraoperative ultrasound applied to monitor spinal cord decompression effect during posterior cervical canal augmentation surgery by observing the application of real-time ultrasound to monitor the morphological changes of spinal cord during posterior cervical canal enlargement plasty.Methods From December 2019 to June 2021,68 cases of cervical myelinosis diagnosed and treated by the Department of Spine Surgery of Chifeng City Hospital were analyzed,and after the relevant examinations of the cases that met the criteria included in the experiment were perfected,the posterior cervical tract single-door spinal canal enlargementoplasty was used,after the spinal canal opening and decompression was completed during the operation,the morphological changes of the cervical spinal cord were monitored in real time during the operation,the imaging performance of the cervical spinal cord and the dural sac was monitored in real time during the operation,and the anteroposterior diameter and left and right diameter of the cervical spinal cord were measured at the most obvious place of spinal cord compression.After measuring the data,the intraoperative spinal cord compression rate was calculated,and the spinal cord compression rate of the patients measured according to the ultrasound image results was divided into group A and group B,group A was the group with adequate decompression,and group B was the group with insufficient decompression.According to the patient’s postoperative JOA recovery rate and intraoperative spinal cord compression rate,statistical analysis was applied to verify the rationality of dividing patients into two groups.Finally,according to the resulting grouping and the intraoperative spinal cord compression rate measured intraoperatively,the subject work characteristic curve is plotted,the best truncation point of the curve is obtained and the conclusion is obtained,when the intraoperative measurement of spinal cord compression rate is less than a certain value,such patients should further improve the anterior combined surgery to achieve better decompression effect.Results When the cervical spinal tract single-door spinal canaloplasty is completed,the cervical spinal cord is decompressed,because the lamina is lifted during the operation,the door is opened,and the occlusion of the bony structure to the cervical spinal cord is lifted,so that the intraoperative ultrasound technique is applied in the cervical spine surgery,so as to obtain a clear imaging performance of the morphology of the cervical spinal cord dural sac and spinal cord.The imaging data obtained during surgery were used to classify patients into type I,type II,and type III.The 68 patients were divided into two groups,group A(adequate decompression group)was type I(n=30 cases)and type II(n=28 cases),and group B(insufficient decompression group)included type III(n=10 cases).Using statistical analysis,the age,sex,and duration of symptoms before surgery in group A(adequate decompression group)were balanced with that of patients in group B(decompression group).The maximum decimal rate of POSToperative JOA score recovery rate(88.45 sec.8.50%)in group A(adequate decompression group)ranged from(80.31% to 99.01%),compared with the maximum decimal range(33.41 to 85.63%)(t=7.034,P<0.001)in group B(decompression group)cases(63.98 s.17.28),P< 0.001,and the difference was statistically significant The maximum decimal value range of spinal cord compression rate measured during surgery in group A(adequate decompression group)was(0.546 people 0.027%),which was(0.502 to 0.625),the maximum small value range of spinal cord compression rate(0.458 shi 0.068)in group B(decompression group)was(0.338～0.556)(t=7.085,P<0.001),and the intraoperative compression rate in group A was higher than that in group B,indicating that the intraoperative spinal cord compression in group A(adequate decompression group)cases was relatively mild,or the compression of the spinal cord had been completely lifted,while group B(decompression group)was relatively heavily compressed,P<0.001,the difference is statistically significant.The above experimental results prove that it is reasonable to divide patients into group A(adequate decompression group)and B group B(decompression deficiency group).The intraoperative spinal cord compression rate data of 68 patients was brought into the subject working characteristic curve(ROCcurve),and then according to the ROC curve,the truncation point was obtained as 0.491,and the sensitivity of this result was1.000 and specificity: 0.800.Further anterior cervical combined surgery is required in cases where intraoperative spinal cord compression is less than 0.491.Conclusion 1.Intraoperative ultrasound technology(IOUS),in the process of using posterior cervical single-door spinal canal enlargement plasty to treat spinal cord spondylosis,can efficiently and intuitively assess the situation of intraoperative spinal cord nerve decompression,and at the same time,to a certain extent,can guide the scope of surgical decompression and evaluate the effect of decompression.2.When the intraoperative spinal cord compression rate < 0.491,there is insufficient spinal cord decompression during the operation,and a joint anterior surgery is required to achieve the purpose of adequate decompression.