Comparison Of Gait Analysis Between Preoperative And Postoperative Cervical Spondylotic Myelopathy

Objective : Cervical Spondylotic Myelopathy is one of the most serious types of cervical spondylosis in clinical classification,because of early onset occult,it is difficult to diagnose and treat in the early time and easy to lead to limb paralysis and other consequences.The quality of life and economic of patients are seriously affected.Gait is controlled by the common operation,body balance and coordination of the central nervous system,lower limb joints and muscles,and the process is very complicated,and there is a possibility of abnormal gait in any process.The related researches show that the upper nerve plays a vital role in the control of limb movement in cervical spondylotic myelopathy,and the primary manifestation of the dysfunction of the spinal cord is the destruction of the lower limb balance.Previous studies have identified that gait analysis is the diagnose and surgical indications of cervical spondylotic myelopathy.It can evaluate the diagnosis,treatment,severity and postoperative curative effect of cervical spondylotic myelopathy objectively and quantitatively.In this study,we collected and analyzed the gait parameters of patients with cervical spondylotic myelopathy pre-and postoperative,the aim of this study was to objectively analyze and accurately describe the gait characteristics of patients before and after operation,and to provide objective data for clinical evaluation of postoperative curative effect.Methods : We selected 18 hospitalized patients diagnosed as cervical spondyotic myelopathy in Spine Surgery of the Dalian Medical University from October to December in 2017.The m JOA lower-limb score,Nurick grade and gait parameters were acquired by the portable gait analysis system which designed by Dalian University of Technology were collected pre-and postoperative one week respectively.Using the SPSS23.0software to statistical analysis of the acquired data,We used paired t-test to compare the pre-and postoperative m JOA lower-limb score and gait parameters and to compare the Nurick grade before and after operation by rank sum test of patients with cervical spondylotic myelopathy,the results of p<0.05 were statistically significant.Results:In this study,the mean m JOA lower-limb score improved from 3.39 to 5.17,the mean Nurick grade improved from 2.44 to 1.11,the difference was statistically significant(p<0.001).The percentage of support duration,the percentage of swing duration were statistically significant(p<0.05),the step length,stride length,step speed,maximum foot clearance,maximum positive foot angle,maximum foot negative angle were statistically significant are significant differences(p<0.001),the percentage of swing duration,step length,stride length,step speed,maximum foot clearance,in the same distance after operation,maximum foot negative angle were significantly increased in the same distance after operation,and the percentage of support phase decreased.Conclusions:(1)The preoperative gait characteristics is that stride length,stride speed is slow,maximal foot clearance,maximum foot angle,maximum foot negative angle,small swing phase percentage,and large support phase percentage.(2)The gait parameters including the percentage of swing duration,step length,stride length,step speed,maximum foot clearance,in the same distance after operation,maximum foot negative angle were significantly increased in the same distance after operation,and the percentage of support phase decreased.(3)Gait analysis is an objective evaluation for cervical spondylotic myelopathy,which can be used in the surgical treatment of cervical spondylotic myelopathy and the evaluation of postoperative recovery,it can provide objective and accurate data for follow-up and curative effect evaluation of patients after treatment.Its future will play an important role in the research and analysis of cervical spondylotic myelopathy,and has great clinical application value.