| Background:With the progress of science and technology and the development of human beings,the pace of people’s life is becoming faster and faster,more time is often spent at the desk,and is of some electronic products,"bow" has become a kind of emerging group,and this leads to the cervical spine burden is getting heavier and heavier,the incidence of cervical spondylosis also increases increasingly,and younger trend is becoming more and more obvious.With the development and need of medicine,we usually divide common cervical spondylosis into four types:cervical spondylotic myelopathy、cervical spondylotic radiculopathy、arteria vertebralis type、sympathetic cervical spondylosis.For the vast majority of patients with cervical spondylosis,we preferred to conservative treatment,including medicine,acupuncture and moxibustion,massage,massage and traction and so on,but in the conservative treatment is invalid or patients with symptoms worsen the situation,surgical treatment has become an irreplaceable treatment,according to different causes and the imaging data we adopt different ways of surgical approach,common with anterior cervical,anteri or cerical approach and posterior cervical spine of three methods for surgical approach,the modified cervical spondylotic myelopathy(MCSM)patients with multiple segments(or more than 3 segments)are usually treated with posterior approach,and posterior single-door expansive laminoplasty has become a major surgical procedure,which has been widely used in clinical practice.But expansive open-laminoplasty(ELAP)feel often occur after surgery in patients with neck,shoulder and back with a heavy,rigid and acid bilges feeling,often causes pain in patients with discomfort,we collectively known AS axial symptoms(AS),and these symptoms most distribution does not conform to the nerve skin section,seriously affecting the patient’s postoperative rehabilitation and quality of life,therefore,in order to improve the symptoms of patients with postoperative axial,we improved a posterior single to open the door for the reconstruction of cervical vertebra rear ligament complex vertebral canal expanding vertebral plate keratoplasty,to study the effect of modified surgical methods on axial symptoms of postoperative patients.Objective:To evaluate an improved expansive open-door laminoplasty(The posteriorspinous process ligament complex is preserved expansive open-doorlaminoplasty),with the significance of modified cervical spondylotic myelopathy in the postoperative axial symptom relief.Methods:A retrospective analysis from June 2016 to March 2018 collected more than 132 cases of segmental spondylotic myelopathy different expansive open-feel the clinical data of laminoplasty,line with cervical spine behind the complex ligament reconstruction of cervical posterior single door vertebral canal expanded processing operation of 74 cases of patients with vertebral plate for group A,To do simple cervical posterior single door vertebral canal expanding vertebral plate keratoplasty(expansive open-door laminoplasty,ELAP),to remove the rear of the spine ligament complex back processing,not the rest of the surgical method is A set of identical 58 patients in group B.Gender,age,operation time,intraoperative blood loss,postoperative drainage volume and follow-up time of the two groups were recorded.Visual analogue scoring(VAS)was used preoperatively,1 week postoperatively,1 month postoperatively,3 months postoperatively,6 months postoperatively and 1 year postoperatively.At the same time,the changes of cervical curvature index(CCI)and the degree of change in the two groups were measured on the preoperative and postoperative X-ray images,and the cross-sectional area of the posterior cervical muscles in the preoperative and postoperative CT images of the two groups were also measured.Results:statistical analysis showed that there was no significant difference in gender, age,operation time,intraoperative blood loss,postoperative drainage volume and follow-up time between group A and group B(P>0.05).There was no statistical significance in the incidence of axial pain in group A and group B before surgery,1 week after surgery and 1 month after surgery(P>0.05),but there was statistical significance in the incidence of axial pain 3 months after surgery,6 months after surgery and 1 year after surgery(P<0.05).In A,B two groups of patients with severe preoperative incidence of axial pain no statistical significance(P>0.05),but 1 week after surgery,postoperative 1 month,3 months after operation,postoperative 6 months and 1 year after the incidence of A group of patients with severe symptoms of axial there were statistically significant(P<0.05),A,B two groups of patients in the preoperative VAS score statistical comparison of no statistical significance(P>0.05),but 1 week after surgery,postoperative 1 month,3 months after operation,postoperative and postoperative June 1 year statistical comparison of VAS score there were statistical significance(P<0.05).There was no statistically significant difference in CCI between group A and group B before and after surgery(P>0.05),while there was statistically significant difference in CCI between group B and group A before and after surgery(P<0.001),and there was statistically significant difference in CCI between group A and group B before and after surgery(P<0.001).The changes of posterior cervical muscle area at the levels of C3/4,C4/5 and C5/6 and postoperative total cervical muscle area were statistically compared between group A and group B,and the results were statistically significant(P<0.001).Conclusion:Reconstruction of cervical spine behind the neck on the ligament complex posterior single door vertebral canal expanding vertebral plate forming technique is relatively simple cervical posterior single door behind the vertebral canal expanding vertebral plate forming no composite spine ligament reconstruction surgery on postoperative cervical axial pain relieve patients there is a big advantage,postoperatively,the incidence of axial pain and significantly reduce the severity of the.The reasons leading to this result were not related to the patient’s gender,age,operation time,intraoperative blood loss,postoperative drainage volume and follow-up time,but related to the change of cervical curvature index CCI and the degree of atrophy of the muscles behind the cervical spine caused by the reconstruction of the posterior spinous process ligament complex of the cervical spine. |
