A Follow-up Study On Recovery Of Neurological Function In Multi-level Cervical Spondylotic Myelopathy After Open-door Laminoplasty

ObjectiveTo investigate recovery process of neurological function after open-door laminoplasty in patients with multi-level cervical spondylotic myelopathy, and analyze the effects of preoperative duration of symptoms on the neurological function recovery process. MethodThe study was a retrospective analysis of 28 patients who underwent open-door laminoplasty for multilevel cervical spondylotic myelopathy by a same group of physicians in the orthopedics of the First Affiliated Hospital of Zhengzhou University from August 2013 to August 2014.16 males and 12 females; aged from 39 years to 65 years, mean 47.5 years; duration of symptoms from 2 months to 3 years, an average of eight months. All cases were followed for 1 year. The time points of follow-up included 3 months after surgery, 6 months after surgery, 9 months after surgery, 12 months after surgery. Using modified JOA score, 10 seconds grip and release test of two quantitative evaluation methods for preoperative and postoperative follow-up of spinal cord function assessment, evaluation of recovery of neurological function. According to preoperative duration of symptoms(<1 year and ≥ 1year) divided into A, B groups: group A(18 people) preoperative duration of symptoms <1 year; group B(10 people): preoperative duration of symptoms ≥ 1 years. According to A, B two sets of data, analyzing the effects of preoperative duration of symptoms on the neurological function recovery process. ResultsPreoperative modified JOA score was 10.1 ± 0.7 points, postoperative 3 months modified JOA score was 12.5 ± 0.9 points, postoperative 6 months modified JOA score was 13.8 ± 0.8 points, postoperative 9 months modified JOA score was 14.1 ± 0.6 points, postoperative 12 months modified JOA score was 14.4 ± 0.5 points, preoperative 10 seconds grip and release test was 15.2 ± 0.8 times; postoperative 3 months 10 seconds grip and release test was 19.3 ± 0.8 times; postoperative 6 months 10 seconds grip and release test was 20.2 ± 0.5 times; postoperative 9 months 10 seconds grip and release test was 21.3 ± 0.6 times; postoperative months 10 seconds grip and release test was 22.2 ± 0.7 times; group A improvement rate of modified JOA score improvement rate was 69.4 ± 16.2%, the increased number of 10 seconds grip and release test was 8.2 ± 0.6 times, group B improvement rate of modified JOA score improvement rate was 55.7 ± 15.1%, the increased number of 10 seconds grip and release test was 6.4 ± 0.5 times. Compared with preoperative modified JOA score, postoperative modified JOA scores were significantly improved,the difference was statistically significant(P <0.05), the postoperative number of 10 seconds grip and release test are significantly improved, the difference is statistically significant(P < 0.05), Logistic linear regression analysis of the two rating indicators showed that the improvement rate of JOA score and the increased number of 10 seconds grip and release test was significantly linear correlation(Pearson correlation coefficient = 0.845, P = 0.000 <0.01). 1 year after surgery, the improvement rate of JOA score and the increased number of 10 seconds grip and release test in first 6 months was significantly higher than last 6 months, the difference was statistically significant(P <0.05). The improvement rate of JOA score and the increased number of 10 seconds grip and release test of group A was higher than group B, the difference was statistically significant(P <0.05) ConclusionsPatients with multi-level cervical spondylotic myelopathy after open-door laminoplasty, the speed of recovery of neurological function was faster in the first 6 months, then the speed was gradually slowed down. The effect of recovery of neurological function in patients with preoperative duration of symptoms ≥ 1 year was worse than the patients with preoperative duration of symptoms < 1 year.