The Analysis Of Whether Resecting Posterior Longitudinal Ligament Or Not In The Anterior Cervical Operation

ObjectiveTo study the longitudinal ligament resection or not after surgery clinical curative effect and clinical significance of anterior portion.MethodRetrospective analysis from January 2015 to December 2016,132 underwent anterior portion road surgery clinical data of spondylotic myelopathy,34 of them after the routine longitudinal ligament,longitudinal ligament resection after 98.Measurement of two groups of patients with preoperative and postoperative JOA scores,average period of JOA,intraoperative blood loss,operative time,complication rates and two groups of patients with the sagittal CT or MRI in preoperative and postoperative spinal cord diameter before and after the narrowest place of the values,all the data statistical analysis by SPSS 23.0,P < 0.01,with statistical differences.Result132 patients were followed up for 3 to 24 months with an average of 12 months.Postoperative review found that clinical symptoms of all patients have different degrees of improvement,including the spinal cord and nerve root compression symptoms,X-ray review suggests that internal fixation in office,good location,MRI showed spinal cord,nerve root compression for different levels of lift.Average 12 months follow-up results suggest that JOA period,after the longitudinal ligament is reserved for(59.15 + 28.27)%,after less than longitudinal ligament resection group(65.95 + 29.38)%(P < 0.01];The posterior longitudinal ligament retention group(2.11 + 1.07)mm was lower than the posterior longitudinal ligament removal group(5.07 + + 1.03).And blood loss and operation time,the longitudinal ligament resection group was obviously higher than preserve group,postoperative complications,the longitudinal ligament resection group below the reserved.Postoperative epidural hematoma of 1 case,immediately after the discovery of the surgical probe,the removal of the hematoma,the operation of the complete hemostasis,the full drainage after the operation was cured;Four cases of cerebrospinal fluid leakage,which were treated after conservative treatment,such as reclining,partial pressure,avoiding coughing and avoiding exertion,etc.Neurofunctional changes were performed in 1 month of hyperbaric oxygen therapy,and 3 months postoperative nerve function was restored to preoperative levels.ConclusionAfter the combination of full text described and analysis of clinical data,longitudinal ligament resection group although intraoperatie blood loss,operating time is reserved group is high,but the incidence of postoperative complications is relatively low,at the same time after the longitudinal ligament resection group is retained in the JOA period has increased significantly,the added value of the spinal sagittal diameter,so the author thinks that road located longitudinal ligament resection after surgery,the bank of China can make more thorough decompression,the spondylotic myelopathy nerve function and the recovery of spinal cord form the recent curative effect is better.