Comparison Of Clinical Characteristics Of Patients With Cervical Spondylotic Myelopathy With Different Degrees Of Developmental Spinal Stenosis

ObjectiveTo compare the clinical characteristics of cervical spondylotic myelopathy patients with different degrees of developmental spinal stenosis.MethodsThe clinical data of 106 patients with cervical spondylotic myelopathy who underwent expensive open-door laminoplasty in the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2019 were analyzed.Patients were divided into mild group(46 cases),moderate group(46 cases)and severe group(14 cases)according to Torg-Pavlov ratio.The clinical data of three groups such as course of disease and first onset age were compared.The changes of spinal cord signals were evaluated by magnetic resonance imaging(MRI)before surgery.JOA score was used to evaluate the neurological function of patients and calculate the recovery rate preoperatively and 1,3,6,12,and 18 months postoperatively,respectively.ResultsThere were statistically significant differences in first onset age,course of disease,minimum recovery time and preoperative hyperintensity changes of spinal cord among the three groups(P<0.05).Compared with the mild and moderate stenosis group,the severe stenosis group showed significantly younger age of first onset,shorter course of disease and time to minimum recovery(P<0.05).There were statistically significant differences in preoperative hyperintensity changes of spinal cord between the severe group and mild and moderate group(P<0.05)and between the mild group and moderate group(P<0.05).There were no statistically significant differences in the maximum recovery time,terminal JOA score and recovery rate(P>0.05).At 1 and 3 months after surgery,there was statistically significant difference in the increased JOA score among three groups(P<0.05).Increased JOA score in severe group was higher than that in mild and moderate group at 1 and 3 months after surgery(P<0.05).ConclusionPatients with cervical spondylotic myelopathy accompanied by severe developmental spinal stenosis have a low age of first symptoms,a short course of disease and high frequency of signal changes in the spinal cord.However,under the premise of timely surgery,their postoperative recovery is fast.The final neurological recovery of patients with different degrees of developmental spinal stenosis is similar.