Comparison Of Clinical Effects Of Modified Posterior Cervical Double Door Laminoplasty And Single Door Laminoplasty With Artificial Bone In The Treatment Of Multilevel Cervical Spondylotic Myelopathy

BackgroundA more serious form of cervical spondylosis,Cervical Spondylotic Myelopathy(CSM),is a frequent affliction in the field of spine.This type of spondylosis causes compression,inflammation and edema of the spinal cord or its pathways due to the deterioration of the intervertebral disc,leading to pain in the upper limbs,numbness in the lower limbs,dizziness,insomnia,and other clinical symptoms.In more severe cases,visual impairment,dysphagia,Dysfunction of urination,and even paraplegia can be seen.As medicine advances,more and more individuals opt to remain in front of the computer for extended periods of time.With the aging population and younger diseases,multi-segment cervical spondylotic myelopathy(MCSM),which can cause three or more segments of spinal cord compression in elderly patients,has had a significant impact on public health.Unfortunately,when a patient is diagnosed with cervical spondylotic myelopathy,the long-term results of non-surgical treatment are usually unsatisfactory.Surgical treatment of an active and effective nature should be employed to decompress the spinal cord and nerve root,either directly or indirectly,to restore the volume of the spinal canal and the intervertebral space,and to encourage the recovery of spinal nerve function.This should help to prevent the deterioration of spinal cord function after spinal cord injury.ObjectiveThe clinical effects of double-door laminoplasty with hydroxyapatite artificial bone and single-door laminoplasty in the treatment of multi-segment cervical spondylotic myelopathy were compared,thereby furnishing a basis for the selection of surgical techniques for MCSM.MethodThis article retrospectively analyzed the clinical data of 73 patients who underwent posterior single and double door laminoplasty due to cervical spinal stenosis from January 2017 to May 2022 in our hospital,including 34 cases of double door laminoplasty modified by hydroxyapatite(HA)artificial bone,and 39 cases of posterior single door laminoplasty Before and after operation,VAS score,NDI index,JOA score and other related indicators,cervical spine mobility,sagittal diameter of vertebral canal,vertebral canal area and other imaging related indicators were used to evaluate whether there was a difference between the two surgical methods,providing a reference for clinical selection of the two surgical methods,and further exploring the efficacy and application value of modified double door laminoplasty with hydroxyapatite artificial bone.Results1.Significantly decreased surgical bleeding volume and postoperative drainage volume in HA group patients(P<0.05),as well as extended operation time(P<0.05),were observed.2.No significant difference in the rate of cerebrospinal fluid leakage,hematoma and infection issues was noticed between the two groups(P>0.05).however,axial symptoms and nerve root paralysis incidence in HA group were decreased(P<0.05).3.No significant distinction was found between the two groups in terms of VAS score,NDI index,JOA score and JOA improvement rate before and after treatment(P>0.05);however,the VAS score,NDI index and JOA score of the two groups post-operation were significantly enhanced compared to those prior to treatment(P<0.05).4.No significant disparity was observed between the two sets in the cervical spine’s range of motion,the sagittal diameter at C5 level,the area of the spinal canal,and the expansion rate of the sagittal diameter(P>0.05)upon comparison.However,the ROM preservation rate and the expansion rate of spinal canal area in HA group were higher than those in the open group(P<0.05)ConclusionThe comparison of artificial bone modified double-door laminoplasty and single-door laminoplasty has had a considerable impact on the treatment of multi-segment cervical spondylotic myelopathy.Compared to single-door laminoplasty,modified posterior double-door laminoplasty has been shown to reduce intraoperative bleeding and total postoperative drainage,axial symptoms,paralysis,and other postoperative complications,while also expanding the volume of the vertebral canal and preserving the range of motion of the cervical spine.Clinical treatment can be tailored to the individual indications of the patient.