| Purpose:To observe the clinical efficacy of Modified Taohong Siwu Decoction combined with unilateral open-door laminoplasty in the treatment of multi-level cervical spondylotic myelopathy(type of qi deficiency and blood stasis).Material and method:The cases came from the patients with multi-segmental cervical spondylotic myelopathy treated in the Department 1 of Orthopaedics,the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from September 2018 to December2020.63 cases were diagnosed as qi deficiency and blood stasis syndrome by TCM syndrome differentiation before operation.According to the order of admission time,the patients were randomly divided into TCM group(n = 31)and control group(n = 32).Background date such as gender,age and course of disease were collected.JOA scores,TCM syndrome scores were performed and measured Cobb angles preoperatively.Both groups were treated with unilateral open-door laminoplasty.During the operation,recorded surgical segment,intraoperative blood loss and operatively duration.Control group routine postoperatively rehabilitation and neurotrophic drugs,One week postoperatively,Modified Taohong Siwu Decoction was applied to the TCM group,Take medicine continuously for one month.Patients in both groups were followed up regularly.The JOA scores were recorded 2weeks,5 weeks and 3months postoperatively.And the improvement rate and excellent and good rate were calculated at the same time.The TCM syndrome scores were recorded at 5weeks and 3 months after operation,and the decreasing rate of TCM syndrome scores was calculated.Lateral cervical DR was performed 2 weeks and 3 months postoperatively,and Cobb angles were measured and recorded.Laminoplasty angles were recorded at 2 weeks and3 months postoperatively from Cervical CT.Bone fusion at the hinge side was observed at 3months postoperatively,and the occurrence of complications was counted.All the results were statistically analyzed.Results:1.Comparison of background data: there was no statistically significant in gender,age,duration of the disease,surgical segment,preoperatively JOA scores,preoperatively TCM syndrome scores,between the two groups.(P < 0.05).preoperatively Cobb Angles,intraoperatively blood loss,operatively duration2.Intra-group comparison between the two groups of patients.The JOA scoress at 2 weeks,5weeks and 3 months postoperatively were higher than those before operation,the difference was statistically significant(P<0.05).3.There was no significant difference in Cobb angles,intraoperatively blood loss,operatively duration between the two groups preoperatively.There was no significant difference in Cobb angles 2 weeks and 3 months postoperatively compared with that before operation(P > 0.05).There was no significant difference in the laminoplasty angles between 3 months and 2 weeks postoperatively(P > 0.05).Bone fusion at the “hinge” side were observed 3 months postoperatively.4.There were no cerebrospinal fluid leakage occurred during operation.No Nerve C5 root paralysis complications,no axial symptoms and door shaft breakage and "re-closing" phenomenon occurred in all patients,5.The JOA scores of patients in the TCM group were higher than those in the control group at 2 weeks,5 weeks and 3 months postoperatively,and the improvement rate of TCM group were better than those in the control group,the difference was statistically significant(P<0.05).6.At 5 weeks,3 months postoperatively,the TCM syndrome scores in the TCM group were lower than those in the control group,and the decreasing rate of TCM syndrome scores in the TCM group were higher than those in the control group,the difference was statistically significant(P<0.05).Conclusion:1.Unilateral open-door laminoplastythe for the treatment of multi-segmental cervical spondylotic myelopathy is effective,the angles of laminoplasty is stabled,could effectively and thoroughly decompress,provided the basis for improve the spinal cord function,the spinal cord function could improve effectively and no influnce on cervical curvature.2.Modified Taohong Siwu Decoction combined with unilateral open-door laminoplasty in the treatment of multi-segmental cervical spondylotic myelopathy could improve the spinal cord function effectively and improve the syndrome of qi deficiency and blood stasis. |
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