Contrastive Analysis On The Effects Of Cervical Spondylotic Myelopathy By Two Differrent Cervical Posterior Decompressions

Objective: This article was designed to evaluate the curative effect oflateral mass screw internal fixation on multi-segments cervical spondyloticmyelopathy and the changes of cervical curvature and intervertebral height inpostoperative patients.Method:50patients suffered from multi-segments cervical spondyloticmyelopathy (≥3segments) were performed surgical operation in ourdepartment from Jun.2006to Jan.2009. They were divided into two groupsaccording to different surgical strategies. Group A was treated with lateralmass screw internal fixation of cervical omni-posterior decompression (26cases). Group B was performed expansive open-door laminoplasty byposterior approach (24cases). This article was designed to make acomparative study about the effect of the two methods according to thechanges of cervical curvature angles and the loss of intervertebral height andthe improvement rate of neck pain in the VAS score.Results: Follow-ups for all the patients were performed from8months to4years (24±5.5months on average). The difference between preoperative andpostoperative cervical curvature angles in lateral mass group A is statisticallysignificant(P＜0.05), but compared with that in unilateral open-door group B,there is no statistical significance(P＞0.05). In group A, there is no statisticalsignificance compared preoperative cervical curvature angles with that of sixmonths later and three years later (P＞0.05) and no obvious loss inintervertebaral height. The results in group B prove to be on the contrary.According to JOA scores, all clinical symptoms in both groups aresignificantly improved, but the postoperative improvement rate in the twogroups indicates no statistical difference(P＞0.05). The improvement rate after half a year and three years later is not different by statistical analysis ingroup A as well(P＞0.05). But in group B, there is statistical significance ofpostoperative improvement rate compared with that of six months and threeyears later(P＜0.05). The improvement rate after three years later in bothgroups is different by statistical analysi(sP＜0.05). The VAS scores reveal thatthe difference of improvement rate between half an year and three years inboth groups is of statistical insignificance(P＞0.05). Instead, the improvementrate after three years later is different by statistically analysis(P＜0.05). Butconversely in group B. In further analysis of the loss of cervical curvatureand intervertebral height, the result showed that in the low-loss group, theimprovement rate and the neck pain in the VAS score after three years laterwere superior to those in high-loss group and were of statistical significance.Conclusion: Lateral mass screw internal fixation of cervical ommi-posterior decompression have many superiorities such as providing satisfieddecompression, reducing the change of cervical curvature and the loss ofintervertebral height, good mechanical intensity and strong stability, lessincidence of cervical axial symptom and higher symptom improvement rate. Itis viewed as an ideal operation method in treating the multi-segments cervicalspondylotic myelopathy at present, which can prevent the recurrence andaggravation greatly.