| Objective: treatment of cervical spondylotic myelopathy with anterior cervical surgery,after operation of cervical physiological curvature changes and postoperative clinical performance improvement to guide future clinical work.Method:Select the Second Hospital Of Dalian Medical Univercity,spinal surgery in June 2013 forecast in December of the 35 cases of single segmental cervical spondylotic myelopathy in parallel studies in patients with anterior cervical spine surgery。With Borden’s measurement of changes of cervical physiological curvature.JOA scoring system for follow-up of spinal cord dysfunction patients to rate their improvement rate and excellent.Results: of the 35 cases were completed,no deaths,and postoperative neurological symptoms without increasing,at the time of follow-up for all patients with varying degrees of improvement in clinical symptoms.Anterior cervical operation fore-arc string from the C4/5 data measured at 2.93 ± 2.66 mm,back-arc string spacing at 8.60 ± 2.51 mm,fore-arc string from the C5/6 data measured at 4.17 ± 3.37 mm,arc-chord length up to 9.00 after operation 3.38 mm,fore-arc string from the C6/7 data measured at 5.17 ± 4.66 mm,arc-chord length reached 9.17 after operation 2.92 mm.Physiologic flexure degree change between different segments of the cervical spine was no significant difference(P>0.05),preoperative postoperative physiologic flexure degree change was statistically significant(P<0.05)In 35 patients,C4/5 Preoperative JOA score-8~14,An average of 11.60 ± 2.92,After 3 days of JOA scoring 10~17 points,JOA scoring 14~17 points after 1 month,averaged 14.67±1.95 points,final follow-up JOA scoring 14~17 points,an average of 15.47 ± 1.77 points.C5/6 JOA preoperative assessment is 6~14 points,an average of 10.92±2.75 points,after 3 days of JOA scoring 8~16 points,an average of 14.00±2.38 points,JOA scoring 9~16 points after 1 month,an average of 14.50±2.38 points,final follow-up JOA scoring 10-17 points,an average of 15.38±1.89 points.C6/7 JOA preoperative assessment is 8~14 points,an average of 11.17 ± 2.86 points,after 3 days of JOA scoring 10~15 points,an average of 13.67 ± 2.94 points,JOA scoring 12~16 points after 1 month,an average of 14.00 ± 2.53 points,final follow-up JOA scoring 14~17 points,15.17 ± 2.56 points average.In 35 patients,C4/5 Preoperative Nurick score,average of 2.82 ± 0.82.After 3 days of Nurick score,average of 1.62 ±0.60.After 1 month,averaged 1.07±0.63,final follow-up Nurick score,an average of 1.14 ± 0.42.C5/6 Preoperative Nurick score,an average of 2.94±0.46.After 3 days of Nurick scoring,an average of 1.73±0.55.After 1 month,an average of 1.15±0.48 points,final follow-up Nurick scoring,an average of 1.38±0.39.C6/7 Nurick preoperative,an average of 2.74 ± 0.34.after 3 days of Nurick scoring,an average of 1.59 ± 0.71.After 1 month,an average of 1.23 ±0.53.Final follow-up Nurick scoring,1.17 ± 0.56 average.In 35 patients of rate of improvement after 3 days: Final follow-up JOA scoring 14~17 points,15.17 ± 2.56 points average.Excellent 8 cases(22.86%),good 13 cases(37.14%),can 13 cases(37.14%),poor 1 cases(2.85%);excellent rate reached 60%,operation 1 months excellent 16 cases(45.71%),good 11 cases(31.43%),can 8 cases(22.86%),poor 0 cases(0%),excellent rate 77.14%;late times follow-up its improved rate: excellent 22 cases(62.86%),good 11 cases(31.43%),can 2(5.17%)cases,Difference 0(0%);Final follow-up of 35 patients after an excellent rate of 94.29%,after anterior cervical surgery for one month,three months and final follow-up JOA significantly improved rate of improvement.Conclusions:(1)the CSM patients after diagnosis,it is recommended that early surgical treatment,spinal cord dysfunction can be effectively improved and early return to normal life and work.(2)according to the patient’s medical history,clinical symptoms and signs and imaging performance in anterior cervical surgery can be effective in restoring and maintaining physiological curvature of the cervical spine,spinal cord compression can be prevented effectively improve postoperative recovery of patients with CSM. |
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