Anterior Slip Phenomenon Of The Vertebral After Corpectomy Surgery And The Clinical Significance

BackgroundThe basic pathological basis of Cervical spondylotic myelopathy is intervertebral disc degeneration which leads to secondary surrounding bone and soft tissue changes caused by spinal cord or spinal pathways of oppression and leads to a different degree of cervical disease clinical spinal cord dysfunction.The diagnosis of cervical spondylosis of the spinal cord is mainly based on clinical manifestation,physical examination and imaging examination.In recent years,the incidence of cervical spondylosis of the cervical spine is high in the middle and old age group,and the quality of life of the patients with severe neurological symptoms.Severe patients need surgical treatment,the purpose of surgical treatment is to relieve nerve compression,relieve clinical symptoms,promote the recovery of damaged nerve function,thereby improving the quality of life of patients.Operation can be combined with anterior,posterior or anterior anterior and posterior approach.Improvement of cervical spinal canal decompression technique,using different surgical neck bone,change the sequence and non osseous tissue after surgery,whether cervical lordosis,activity changes affect the functional recovery of spinal cord,there are still many disputes.With the increase of the number of operations,most of the patients obtained good clinical effect and improved the quality of life.But some patients did not get a good clinical effect,there were complications associated with surgery.ObjectiveTo investigate the phenomenon and mechanism and clinical significance for forward phenomenon of the vertebrar after corpectomy surgery.MethodsRetrospective analysis of January 2010 to April 2013,follow-up of 164 cases,88 males and 76 females;Mean 56.2 year;31 cases for C4 corpectomy,87 cases for C5 corpectomy,46 cases for C6 corpectomy.CT in cervical sagittal middle layer scanning as the center,respectively measure the vertebral canal wall and adjacent vertebral bodies left above and below the line distance,and then after the two layer,averaging.The use of fast clustering method,the operation of vertebral shift distance as variable,according to the size of the forward distance,90 cases classified as group 1(Forward greatly),the 74 cases classified as group 2(Forwad shot).The recovery rate was calculate comparing the Japanese Orthopaedic Association(JOA)scores before and after operation.ResultsThe average following up was 29.5 months.The operation of vertebral reach distance larger occurrence operated by chi square test incidence rate,no significant difference(x2=0.01,P=0.996),Displacement of cervical curvature index and operated vertebra has a positive correlation(r=0.724).Calculation of two groups in the postoperative incidence of reduced diameter diagonal,group 1 was higher than that of group 2(x2=4.45,P=0.035).Unsatisfying group appeared obvious forward of vertebral operation patients was significantly higher than that in the group with satisfactory efficacy(P<0.05).ConclusionThe local curvature of the vertebral of treatments changes caused different degree of forward displacement trend after corpectomy surgery for cervical myelopathy,this shift may cause the secondary compression from the rear of the spinal cord.