Clinical Effect Of Three Different Cervical Posterior Operative Methods For Treatment Of Multilevel Spinal Cord Compression And Severe Cervical Spondylotic Myelopathy

Objective To explore clinical effect of three cervical posterior surgery procedures for treatment of multilevel spinal cord compression and severe cervical spondylotic myelopathy (CSM) according to a prospective study, and to provide a theoretical basis and reference for cervical posterior surgical operations. Methods A total of93patients with multilevel spinal cord compression and severe CSM were treated with three cervical posterior procedures from January2007to December2010was analyzed.Total patients were randomly divided into A,B,C three groups by lot. Of them,27patients underwent traditional cervical open-door laminoplasty in group A.32patients received laminectomy lateral mass screw fixation in group B.34patients received laminoplasty and lateral mass screw fixation in group C.The preoperative and postoperative JOA score,cervical curvature,ranges of neck motion,axial symptoms,C5nerve root palsy were recorded. Using software SPSS20.0for statistical data processing analysis and statistical t-test was used between the two different groups respectively. Results The improvement rate of JOA score:There was no significant difference in JOA scores after three months of the surgery between the three groups.But in the last fellow-up,the JOA scores was higher in the group B and C (There was no difference between the group B and C)than in the group A. The improvement of cervical curvature:It was better in the group B and C than in the group A.Ranges of neck motion:There were no significant difference between the three groups.Axial symptoms:The incidences of axial symptoms were lower in the group B an C (There was no difference between the group B and C)than in the group A.C5nerve root palsy:There was no significant difference between the three groups. Conclusion Three cervical posterior surgical procedures for treatment of multilevel spinal cord compression and severe CSM all can achieve satisfactory results.The patients with the operation of cervical posterior laminectomy and lateral screw fixation or laminoplasty and lateral mass screw fixation(group B and C)for multilevel multilevel spinal cord compression and severe CSM can more effectively improve neurological function,recover and maintain cervical curvature and reduce the incidence of axial symptoms than patients with operation of traditional cervical open-door laminoplasty(group A). The surgery of laminectomy lateral mass screw fixation and laminoplasty and lateral mass screw fixation can be used as the best choice for the treatment of multilevel spinal cord compression and severe cervical spondylotic myelopathy,and make reasonable selection according to the patient’s physical condition.