| OBJECTIVE: This study compared and analyzed the clinical effect and the incidence of complications of cervical spondylotic myelopathy(CSM)caused by ossification of posterior longitudinal ligament by posterior single-door laminoplasty and decompression of cervical spinal canal with metal band anchors and silk thread fixed portal axis.METHODS: This study collected the date of the case that the cervical spondylotic myelopathy caused by Multi-Segments Cervical Ossification of Posterior Longitudinal Ligament from January 2016 to December 2017 and was treated by the same surgeon in the Department of Orthopaedics,the Second Affiliated Hospital of Nanchang University,A retrospective analysis of this data series was performed.Open the spinal canal to enlarge the decompression.A total of 40 patients were included in the analysis of this group.Among them,20 patients who received single-door surgery with metal-line anchors were called the anchor group;20 patients who received silk-bundle fixation and single-door surgery were called silk group.The operation time,intraoperative blood loss,total drainage volume,postoperative C5 nerve root palsy,postoperative axial symptoms,postoperative incision healing or infection were recorded in the two groups.modified Japanese Orthopaedic Association(mJOA)score,Visual Analog Scale(VAS)score,The Neek Disability Index(NDI)and cervical curvature index(CCI)were obtained the 3rd month after surgery,the 6th month after surgery,and the 12 th month after surgery.Data were analyzed by(NDI)and statistical analysis using SPSS22 statistical software.The difference was statistically significant at P<0.05,P > 0.05 had no statistical significance.RESULTS: All the 40 patients completed the postoperative follow-up.There were no statistically significant differences in age,gender,duration of disease and Number of lesion segments(P>0.05)in the cases of anchor group and silk group.The intraoperative blood loss anchor group was slightly more than the silk group(P>0.05);the operation time anchor group was longer than the silk group(P<0.05);the total drainage volume anchor group was slightly lower than the silk group(P >0.05).The number of cases of C5 nerve root palsy was lower in the anchor group than in the silk group(P<0.05).The postoperative cerebrospinal fluid leakage was lower in the anchor group than in the silk group(P>0.05);the incision was poorly healed or the infection rate was anchored.The group was lower than the silk group(P>0.05).Preoperative mJOA score,NDI,VAS score,CCI: Anchor group was similar to silk group(P>0.05).After the operation,the mJOA scores were relieved in the 1st week after operation(P>0.05),and the NDI and VAS scores were slightly worse than those before the operation(P>0.05).The mJOA scores in the the 3rd,the 6th and the 12 th month were improved.The situation was better than that of the silk group(P<0.05).There was no significant difference in the improvement rate of mJOA between the two groups at the 1st week after operation(P>0.05).The improvement rate of mJOA in the the 3rd,the 6th and the 12 th month after operation was better than that of the silk group(P<0.05).The NDI anchor group was superior to the silk group at the 3rd,the 6th and the 12 th month after operation(P<0.05).The “re-closing” anchor group was slightly lower than the experimental group at the 12 th month after operation(P<0.05).The CCI silk group was lower than the anchor group at the 6th and the 12 th month after operation(P<0.05).CONCLUSION: Posterior cervical single-door laminoplasty and decompression with metal-banded anchor and silk-line fixation have achieved satisfactory clinical results.Posterior cervical laminoplasty and decompression with single open door cervical spinal canal with metal band anchors for the treatment of cervical spondylotic myelopathy with ossified posterior longitudinal ligament has better recovery of nerve function and cervical spine function.The incidence of "re-closing" after operation is lower and the effect is better. |
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