Dcs Combined The Csm Mri Images And Single-door Surgery

Objective:1. To explore the developmental cervical canal stenosis (DCS) group of spinal cord development and differences in normal people by measuring their MRI images.2. To evaluate and analyse comprehensively the effect of posterior single open-door cervical expensive laminoplasty with anchor fixation on DCS with Cervical Spondylotic Myelopathy (CSM).Methods:1.30 cases of DCS is set to be observation group and another 30 patients without DCS was set as control group.(1)The C3-6 sagittal diameter of the spinal cord was measured at the midvertebra level on the MRIT2-weighted sagittal image.Also.the C3-6 Pavlov ratio was measured from the cervical standard lateral X-ray film.(2)The difference of the sagittal diameters of the spinal cord between the two groups was compared using t test.The correlation between sagigttal diameter of spinal cord and Pavlov ratio was checked using Pearson correlation analysis.2.The effect of surgical treatment of single open-door expensive laminoplasty by anchor fixation on the 36 cases with DCS and CSM was evaluated and analysed by the JOA scores system, axial symptoms appraisal and the neck disability(NDI) questionaire.Results:1.The C3-6 sagittal diameter of the spinal cord in the DCS group is smaller than in the "normal" group(p<0.05).The sagittal diameter of the spinal cord is correlated with the Pavlov ratio(r=0.36,p<0.05).2.All the 36 patients were followed up 3months,12 months after surgery.The JOA score was improved from 7.5±3.71 points preoperation to 15.3±1.7 points 12 months postoperation,and the improvement rate was 81.05±14.37 (%).There was only 5 cases with axial symptoms happened afer operation, and the incidence rate was 13.9%;The C5 canal sagittal diameter preoperative was 9.6±2.4mm,and was 14.9±2.1mm 2 weeks after operation, 14.7±1.9mm 12 months after operation.There was significant difference between preoperation and 2 weeks postoperation(p<0.05). There was not significant difference bwtween 2 weeks and 12 months (p>0.05);The NDI index was 0.41±0.05 3 months after operation, and was 0.12±0.03 12 months after operation (P<0.05).Conclusion:1.The sagittal diameter of the spinal cord in the DCS group is smaller than non-DCS group from the MRI image;There is partly correlation between the sagittal diameter and the Pavolov ratio.The more developed spinal stenosis,the smaller sagittal diameter is.2.The surgery,single open-door expansive laminoplasty with anchor fixation,of treating DCS with CSM can significantly improve the neurological function, prevent the door "re-closed" effectively,reduce the incidence of axial symptoms and other related complications,and improve cervical spine function obviously.The curative results is satisfactory.