Different Posterior Decompression For Patients With Spinal Canal Stenosis In The Upper Thoracic And Cervical Spine

Objective:To retrospectively investigate the clinical manifestation of patients with spinal canal stenosis in the upper thoracic and cervical spine receiving different posterior decompression.Methods:Between January 2010 and December 2015,18 patients of that complicated phenomenon were studied.Among them, there were 6 males and 12 females. The ages ranged from 42 to 74 years with a mean age of(57.89±7.19) years. The course of disease ranged from 2 to 84 months,with an average of( 29.72±27.7) months. 10 cases received single-staged combined decompression(group A)while the other 8 cases received double-staged posterior decompression(group B).The JOA scores and excellent and good rate were comparatively studied.Results:The mean operation time was 147 min ranging from 90 to 220 min.The volume of blood loss ranged from 50 to 500 ml. 1 patient was complicated with C5 nerve root traction symptoms,which resolved after cor-responsive management.1 patient was complicated with fat liquefaction. The symptoms of two cases had no improvement or even worse, which improved after second operation in 6 months and 1 year.These cases were followed up for 12 to 25 months,with an average of15.40 months.The patients with postoperative neurological deficit improved to differential degrees. No statistically significant inter-group difference existed in preoperative JOA score(9.10±2.64vs9.13±2.17)and postoperative JOA score(15.40±1.17vs13.75±4.50), but statistics analysis showed that the excellent and good rate of group A(100%) was better than group B(62.5%).Conclusion:All the approaches are effective for the treatment of patients with spinal canal stenosis in the upper thoracic and cervical spine, while single-staged combined decompression is better than double-staged operation.