Comparison Of The Effect Of Two Surgical Methods On The Treatment Of Cervical Spondylosis Myelopathy

1 Background and ObjectivePinching cervical spondylosis is one type of cervical spondylosis which include single or multiple cervical disks herniation,ossification of posterior longitudinal ligament and ossification of ligamenta flava,constricting the spine cord and nerve root anteriorly and posteriorly.Patients with this type of disease may have manifestation of paresthesia,paralysis and pain of upper and lower limbs,abnormal tendon reflex,unable to do fine movement,and staggering gait.What`s the worst,Patients can accompany with disorders of urination and defecation.Systematic pinching cervical spondylosis may have influence on patient`s daily life badly,decreasing the quality of living remarkably.Treatment of this disease in clinical are operations.But patient`s condition is always complicated,with elder age and some basic diseases like hypertension or diabetes mellitus,which make the ideal choice of operation very difficult.The most prevalent surgical procedures include anterior cervical approach surgery,for instance,anterior cervical discectomy and fusion,and posterior cervical approach surgery,like posterior cervical spinal decompression or laminoplasty,and the combined posterior-anterior approach.Recent studies indicated that there is limitation using anterior cervical approach surgery or posterior cervical approach surgery alone.But for combined posterior-anterior approach,it is much more complicating an operation and there some discussions about whether proceed the operation in single-stage or two-stage,for single-stage with the longer operation time and larger trauma and for two-stage with need of another operation.We compare the clinical effects of two groups patients with pinching cervical spondylosis using the two surgery approaches in order to explore the ideal surgical treatment for this type of cervical spondylosis myelopathy.2 MethodsRetrospective analysis from 1^st January 2012 to 31^thh December 2016 in our hospital for patients with single or multiple segments disk herniation,ossification of posterior longitudinal ligament,ossification of ligamenta flava that leading to pinching cervical spondylosis.For total patients of 77 cases,single-stage combined posterior-anterior approach operation group?Group A?31 cases,two-stage combined posterior-anterior approach operation group?Group B?27 cases.For early follow-up investigation,we compared the surgery period,surgery bleeding volume,the volume of drainage and JOA score,and VAS score before and after operation in 3,6,12 months and the last time,and neurologic improvement rates in 3,6,12 and the last time after operation,were analyzed.3 ResultsOperation time in two groups had no statistical significance between the groups?p>0.05?.The difference of Blood loss during operation and volume of drainage post-operation in two groups had statistical significance between two groups?p<0.05?.As for the difference of JOA score before operation,3,6,12 months after operation and at the last follow-up,and VAS scores before operation,3,6,12months after operation and at the last follow-up,there was no statistical significance between two groups?p>0.05?.The difference of neural function improvements 3,6,12 months after operation and at last follow up between two groups was no statistical significance?p>0.05?.4 Conclusion1.Both single-stage and two-stage combined posterior-anterior approach can achieve excellent clinical efficacy and accompany with remarkable improvements in clinical symptoms.2.Two-stage combined posterior-anterior surgery has shorter operation time,less volume of bleeding during operation and drainage after operation than single-stage combined posterior-anterior approach...