Retrospective Study Of The Operative Treatment For Cervical Spondylotic Myelopathy

Objective:To study the relationship between the factors of the postoperative effect and the time of operation,age,situation before operation,the number of fusion segment,the method of anterior or posterior operation,the change of cervical fusion intervertebral height,postoperative cervical curve,etl,and establish a multiple linear regression equation to offer the valuable refer of the operative treatment for cervical spondylotic myelopathy.Method:613 patients with cervical spondylotic myelopathy were followered up in the affiliated hospital of shanxi medical University from April 2004 to October 2006 by the way of letters,telephone and outpatient bespeak,and review the date of case history.JOA score were collected before and after operation,and the curve of cervical were measured.Statistical regressive analysis was conducted to evaluate the operation curative effect of anterior and posterior method,the curative effect analysis of operation time,the operative effect of single and multiple segment,the curative effect of cervical curve of before and postoperation,and to offer the guidance for clinical prectise.Result:The curative operation effect of cervical spondylotic myelopathy is related to age,disease course,and JOA score before operation.There is no statistical significance between the curative effect and patients gender,the method of inter fix operation and the method of bone embedded.D value of the anterior method,the hight of the cervical fusion segment,Cobb angle and ROM angle are obviously improved,and the degree of the improved is positive correlated with the curative effect.There is no statistical significance as to D value of posterior method and ROM angle.Factors that affect the anterior operative effect of cervical spondylotic myelopathy are disease course,JOA score before operation and age.The multiple linear regression equation of the anterior method is y=64.915-0.642xl+2.140x2-0.143x3.Factors that affect the posterior operative effect of cervical spondylotic myelopathy are JOA score before operation,age and disease course.The multiple linear regression equation of the posterior method is y=65.469-0.298xl-0.400x2+1.882x3.Conclusion:Factors that affect the operative effect of cervical spondylotic myelopathy are: 1.Age:the older of the patient,the poorer of the curative effect.2.Disease course:the longer of the disease course,the more miserable of the curative effect.3.JOA score before operation:the lower of the JOA score,the poorer of the curative effect.4.Method of operation:Both anterior and posterior operation method have obviously curative effect,but the anterior method is superior to posterior method.5.The situation of interior fix:the effect of interior fixation is superior to the effect without interior fixation.The curative effect is not related to gander,method of bone embedded and method of interior fixation.Factors that affect the anterior operative effect of cervical spondylotic myelopathy are disease course,JOA score before operation and age.The curative effect is positive correlated to the changement of D value and the hight of the fusion segment.Factors that affect the posterior operative effect of cervical spondylotic myelopathy are JOA score before operation,age and disease course.Earlier operation should be performed as soon as CSM is diagnosed,and the candidate of operation and method of operation should be strictly assessed.