The Study Of Selection Of Fusion Methods In Anterior Cervical Operation For Cervical Spondylotic Myelopathy And The Analysis Of The Therapeutic Effects And Influencing Factors

Objective:To explore the selection of fusion methods in anterior cervical operation for cervical spondylotic myelopathy and the factors that influence the effects of operations and surgical complications.Methods: According to the inclusion criteria and exclusion criteria,51patients(27 males and 13 females)with cervical spondylotic myelopathy who underwent operative treatment between April 2008 and October 2010 in Affilated Hospital of Shan dong University of Triditional Chinese Medicine were included in this study. They were conducted a questionnaire survey, physical examination and radiography,and followed up for more than 1 years by telephone or letters after postoperative. We scored the functions of spinal cord before and after the operations with JoA scaleand the functional grading system of Nurick and calculated the improvement rate and fineness rate.Statistical analytical methods(independent sampler T test,One-Way ANOVA,Logistic regression analysis)were performed to study the relation between factors and the surgical outcome of cervical spondylotic myelopathy.Result:The fhusion rate of iliac autograft , cage implantation or titanium mesh cage was satisfactory, but that of allogeneic bone allograft was lower.The curative effect of iliac autograft and that of cage implipantation and that itanium mesh cage were comparably better than that of allograft. Disease course (P<0.01),with the preoperative injury (P<0.05),with a change on images of MRI (P<0.05) are the factors impacting operative results.It can be observed that there are relation between the excellent good rate of the JOA sore and disease course(P<0.01),with a change on images of MRI (P<0.05) in the logistic regression.Conclusion:The key point of the treatnent of cercvical spondylotic myelopathy lies in through decom pression and effecttive bone graft fusion,further more ,different methods of fusing affect the curative effects significantly. Iliac autograft ,cage implantation ang titanium mesh cage are good fusion methods in anterior cervical operation for cervical spondylotic myelopathy, however allograft is not an appropriate method in this circumstance. The JoA score can be improved by taking the optimal selection of fusion methods and the high improvement and fineness rates can be achieved at the same time.Thc complications can be decreased·too.The disease course, preoperative injury and a change on images of MRI is the factors that affects the therapeutic effects of operations.