| Objective: To investigate the effect of short segment(The number of segments is less than or equal to 3)posterior cervical short-segment single open-door decompression and traditional long segment(C3 ~ C7)posterior cervical short-segment single open-door decompression in the treatment of cervical hyperextension injury?Methods: 68 patients who underwent posterior cervical surgery in our hospital from November 2015 to November 2017 were analyzed.Among them,37 patients underwent posterior cervical short segment decompression and 31 patients underwent posterior cervical traditional long segment decompression.According to the follow-up results,the gender,age,operation time,intraoperative bleeding volume,JOA score,VAS score,neurological improvement rate and the incidence of axonal symptoms(AS)and C5 nerve root paralysis(NRP)at the last follow-up were compared and analyzed.Results: There was no significant difference in gender and age between the two groups(P>0.05).The JOA score of the posterior cervical short segment decompression group was(8.05±2.86)before operation,(9.08±2.45)at 3 months after operation and(13.16±3.02)at the last follow-up.The VAS score was(7.41±1.40)before operation,(6.03±0.74)at 3 months after operation and(1.54±1.02)at the last follow-up.The JOA score of the posterior cervical long segment decompression group was(8.13±2.88)before operation,(9.39±2.32)at 3 months after operation and(13.26±2.53)at the last follow-up.The VAS score was(7.26±1.57)before operation,(6.21±0.89)at 3 months after operation and(3.71±0.97)at the last follow-up.There was no significant difference in JOA score between the two groups before operation,3 months after operation and the last follow-up(P>0.05),but there was significant difference in VAS score between the three months after operation and the last follow-up(P<0.05).The improvement rate of nerve function,intraoperative bleeding volume,operation time and hospitalization days at 3 months and the last follow-up were(40.7±8.2)%,(73.2±13.2)%,(204.32±148.48)mL,(179.86±44.05)min and(14.51±4.65)days in the short segment of cervical spinal canal decompression group and(42.4±10.8)%,(74.9±14.3)%,(275.29±155.06)mL,(201.03±42.23)min and(17.39±5.86)days in the traditional posterior segment of cervical canal canal decompression group,respectively.There was no significant difference in the improvement rate of nerve function between the two groups at 3 months and the last follow-up(P>0.05),the amount of bleeding,hospitalization time and operation time in the posterior cervical short segment decompression group were less than those in the traditional posterior cervical decompression group(P<0.05),.At the last follow-up,the incidence of axonal symptoms and C5 nerve root paralysis was 12 ~ 38 months in the posterior cervical short segment decompression group,with an average of21.86±9.76 months.At the last follow-up,the incidence of axonal symptoms was 8.1%,and the incidence of C5 nerve root paralysis was 2.7%.In the posterior cervical long segment decompression group,the follow-up time was 12~38 months.Axial symptoms(AS)and C5 nerve root paralysis(NRP)were 25.8% and 19.4% at the last follow-up.Compared with the two groups,the incidence of axonal symptoms and C5 nerve root paralysis in the short segment decompression group was lower than that in the long segment decompression group(P<0.05).Sixty-eight cases were successfully operated.No infection,cerebrospinal fluid leakage,loosening of internal fixation and other complications occurred after operation.Conclusion: Compared with traditional posterior cervical decompression,the selection of appropriate patients with posterior cervical short segment spinal canal decompression can also achieve similar results.The short-segment decompression operation time and hospitalization time are shorter,and the amount of intraoperative bleeding is less,and the incidence of axonal symptoms(AS)and C5 nerve root palsy(NRP)after operation is smaller,which can significantly improve the long-term subjective symptoms of patients. |
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