Comparative Study Of Traditional Scoring System And Gait Analysis Of Cervical Spondylotic Myelopathy

Background: Cervical spondylotic myelopathy due to the onset of occult,onset is slow,it is difficult to achieve early diagnosis and early treatment.Severe cervical spondylotic myelopathy causes irreversible damage to the nervous system due to chronic ischemia and hypoxia of the spinal cord,which seriously affects the patient's quality of life and at the same time imposes a huge burden on the society and the patient's family.In recent years,with the development of the level of technology and the increase of clinical research,especially with the advancement of modern medical diagnostic techniques,the diagnostic techniques of cervical spondylotic myelopathy have greatly improved,but early diagnosis and treatment of cervical spondylotic myelopathy There are still controversies regarding the formulation of the plan,and there is still a lack of objective and quantitative evaluation techniques in clinical practice.Studies have shown that analyzing the gait characteristics of patients has guiding significance in the diagnosis of cervical spondylotic myelopathy.The sensitivity and specificity of gait analysis in the diagnosis of cervical spondylotic myelopathy remains to be studied and validated.Objective: To explore the feasibility of portable gait analyzer for clinical diagnosis of cervical spondylotic myelopathy,to understand the gait characteristics of patients with cervical spondylotic myelopathy,and to determine whether gait changes can be used for the diagnosis of cervical spondylotic myelopathy as an objective and quantitative indicator.Early diagnosis of cervical spondylotic myelopathy.Methods: Patients with cervical spondylotic myelopathy who were hospitalized in the spine surgical ward from the First Affiliated Hospital of Dalian Medical University between September and November 2017 were selected.Diagnostic criteria meet the diagnostic criteria for cervical spondylotic myelopathy in the cervical spondylosis and rehabilitation guidelines of the Chinese Medical Association.Excluding patients with affected gait diseases,18 patients with cervical spondylotic myelopathy were included in the case group and 18 healthy adult volunteers were included in the control group.The subjects were measured using a portable analyzer that was designed by Dalian University of Technology in the First Affiliated Hospital of Dalian Medical University.SPSS 22.0 software package was used to perform independent sample T test,Pearson correlation analysis,draw ROC curve and find the most For the best cutoff value,the difference was statistically significant at P<0.05.Results: 1.The percentage of supporting phase in patients with cervical spondylotic myelopathy increased,the percentage of oscillating phase decreased,and strided Longer shortening,reduced clearance,the largest reduction in the angle of flexion,and the decrease in the maximum dorsiflexion angle.2.Improved Japanese Orthopaedic Society scores in patients with support phase,percentage of support phase,percentage of oscillating phase,clear correlation with clearance;correlation with gait cycle,stride length,and maximum dorsiflexion angle;different modified Japanese Orthopaedic Association There was no statistical difference between the gait parameters of cervical spondylotic myopathy patients who scored.3.The Nurick scores of patients and gait cycle,support phase,percentage of support phase,swing phase percentage,clearance,maximum dorsiflexion angle Strong correlation;correlation with long-step presentation;There was a statistically significant difference in the maximum dorsiflexion angle between patients with cervical spondylotic myelopathy with different Nurick scores,and there were no statistically significant differences in other gait parameters.In this study,there are two gait parameters that can be used for the diagnosis of cervical spondylotic myelopathy,which are the percentage of the support phase and the maximum flexion angle.By calculating the Youden index,when the percentage of the gait parameter support phase exceeds 62.278%,the subject may be considered to have cervical spondylotic myelopathy;when the maximum flexion angle of the gait parameter is less than 25.021 o,it can be considered that The test subject may have cervical spondylotic myelopathy.Conclusions: 1.The patient's modified Japanese Orthopaedic Society score was related to the percentage of support phase,support phase,percentage of swing phase,clearance,gait cycle,stride length,and maximum dorsiflexion angle;patient gait modification and improvement of Japanese Orthopaedic Association The score was irrelevant;the patient's Nurick score was related to the gait cycle,support phase,percentage of support phase,swing phase percentage,clearance,maximum dorsiflexion angle,and stride length;the patient's maximum dorsiflexion angle change was consistent with the Nurick score change.2.Gait analysis can be used as a diagnostic tool for cervical spondylotic myelopathy.The percentage of the supporting phase and the maximum angle of flexion can be used as a diagnostic basis for cervical spondylotic myelopathy.