A Study On The Correlation Between Preoperative Cervical Curvature And The Effect Of Single Open-door Laminoplasty

Objective:To explore the correlation between different cervical curvature before surgery and pain relief,nerve function recovery,incidence of C5 nerve root paralysis,and incidence of axial symptoms in posterior cervical single-door expansive vertebral canal plasty.Methods:A retrospective analysis was performed on 100 patients with cervical spinal cord injury(OPLL)of cervical spondylotic myelopathy(CMS)admitted to our hospital from January2016 to December 2017.The patients were divided into four groups according to the cervical curvature before surgery and underwent posterior cervical single-door expansive spinal canal plasty using the same surgical method.Group A preoperative cervical curvature(Cobb < 0 °)23 cases,8 patients were male,female 6 cases,the average age of 53 + /-10.33(36-68),average Cobb Angle was 4.29 + /-3.667.Group B preoperative cervical curvature(0 ° or less Cobb < 10 °)32 cases,24 cases of male,female 8 cases,an average of 53.56 + /-9.353 years old(40-71 years),Cobb Angle was 5.25 + /-2.615 on average.Preoperative cervical curvature of group C(10 °or less Cobb < 20 °),30 cases of male 21 cases,9 cases of women,an average of 55.83 + /-10.396 years old(36-76),Cobb Angle was 13.63 + /-2.906 on average.Group D preoperative cervical curvature(20 ° or less Cobb < 40 °)24 cases,male 21 cases,3 cases of women,the average age of 57.58 + /-8.88(44-78),Cobb Angle was 26.13 + /-5.067 on average.For all into the group of patients with preoperative and postoperative year JOA score(Japanese Orthopaedic Association Scores)and calculate the neural function recovery rate,preoperative andpostoperative year line of VAS score(visual analogue scale)assessment before and after surgery in patients with pain recovery and follow-up of patients with four groups of incidence of postoperative C5 nerve root palsy,axial symptom morbidity,calculate and compare each operating time,blood loss,hospitalization time,etc.,are side by preoperative cervical vertebrae X-ray,Preoperative Cobb Angle of cervical curvature was measured and calculated,and the data were statistically analyzed.Results:All the four groups were followed up for 12-24 months with an average of 17.6 months.The recovery rate of JOA score was(48.3+ /-45.6)% in group A,(50.8+/-37.5)% in group B,(47.10+/-43.4)%in group C,and(48.8+/-38.0)%in group D.Patients in the four groups showed different degrees of postoperative pain relief,and the VAS score of the relief degree was(1.00+/-1.18)in group A,(0.66+/-1.07)in group B,(0.77+/-1.43)in group C,and(0.67+/-1.24)in group D.There was no significant difference between the four groups(P=0.836).The incidence of symptoms of C5 nerve root paralysis was 0.0% in group A,12.5% in group B,0.0% in group C,and 4.2% in group D,with no statistically significant difference(P=0.064).The incidence of axial symptoms was 21.4% in group A,18.8% in group B,13.3% in group C and 33.3% in group D,with no statistically significant difference(P=0.067).The average operation time of group A was 152.7+/-43.9min,the average hospitalization time was 13.1+/3.0 days,and the blood loss was400.0+/-370.3ml;the average operation time of group B was 162.7+/-49.5min,the average hospitalization time was 14.3+/-4.2 days,the blood loss was 452.7+/-316.5ml;the average operation time of group C was 150.5+/-38.2min,the average hospitalization time was14.5+/-5.6 days,the blood loss was 392.1+/-285.4ml.The average operative time was152.2+/-43.9min in group D,the average hospitalization time was 15.1+/-4.2days,and the blood loss was 392.3+/-257.3ml.The difference between the two groups was not statistically significant(P=0.710 P=0.654 P=0.909).Conclusion:Within a certain range,there was no significant correlation between preoperative cervical curvature and the curative effect of posterior single-door laminoplasty.Within a certain range,there was no significant correlation between preoperative cervical curvature and the incidence of c-nerve root paralysis symptoms after single-door laminoplasty.Within a certain range,there was no significant correlation between preoperative cervical curvature and the incidence of axial symptoms in single-door laminoplasty.