Clinical Effect Of Anterior And Posterior Correction For Cervical Vertebral Deformity

Objective: To analyze the clinical effect of anterior and posterior correction for cervical deformity, and provide a reference for clinical choice of surgical approach.Methods: A retrospective analysis of 2008 January-2013 year in December, the First Affiliated Hospital of Guangxi Medical University were treated 61 cases of patients with cervical kyphosis.37 male cases, 24 female cases, aged between 2 to 78 years old, the average(43.7±15.0) years old. According to the result causes deformity is divided into: latrogenic(mainly for the cervical laminectomy and internal fixation in patients without) kyphosis in 29 cases, traumatic kyphosis in 16 cases,12 cases of degenerative convex, convex deformity in 4 cases after the disease.The preoperation JOA score of 5 to 12, average(8.70±1.67); preoperative inflection Cobb angle between 9.3degrees to 28.2 degrees, the average(14.4±3.3) degrees, cervical kyphosis correction surgery. Among them 39 cases were anterior operation ﹝Cobb angle between 9.3 degrees to 19.5 degrees, the average(14.1±2.7) degrees, including: latrogenic patients involving 3 or less segments; patients with traumatic injury of anterior column and posterior column or column intact;patients were mainly involved in degenerative anterior column, column and intervertebral disc in part associated with ossification of the posterior longitudinal ligament; diseases of patients abnormalities involving less than 3 segments. All of the above cases without cervical posterior column bony fusion, preoperative JOA score(8.54±1.70) ﹝; 22 cases underwent posterior operation ﹝Cobb angle of 9.6 degrees to 28.2 degrees, the average(15.1 ±4.3)%, among them: latrogenic patients involving 3 or more segments; patients with traumatic for the column or column with damage but no bony shift cases; for patients with degenerative posterior column bony fusion occurred; the disease of patients involving more than three cases of vertebral body. All cases had no cervical anterior column bony fusion, the mean preoperative JOA score(9± 1.63) ﹝. Record of operation time, operation amount of bleeding, hospitalization time of patients and analysis changes in preoperative, postoperative and final follow-up, the JOA score, Cobb angle.Results: The average operation time of 39 patients with anterior surgery was(111.6 38.4) min, the average blood loss was(335.6 308.3) ml, the average hospitalization time was(12.6 + 6) days; postoperative Cobb angle was(5.1±1.2) degrees that was significantly reduced compared with the preoperative, immediate postoperative kyphosis correction rate average(63 ± 9.4)%; 12 to 31 months of follow-up, an average of about 21 months, at the time of the last follow-up Cobb angle for an average of(6.5±1.3) degrees compared with the preoperative obviously decreases, the average loss of correction rate was(16.2±7)%; within a week after operation the JOA score was(11.82±1.55) points, at the time of the last follow-up JOA score was(15.53±1.41), compared with that before operation were significantly improved,at the last follow-up, the improvement rate was(83.8±13)%. 22 cases of posterior operation in patients with the average operation time was(146.5±60.3) min, average bleeding in operation was(661.4±330.2) ml, the average hospital stay was(17.3±6.4) days; postoperative Cobb angle was(9.1±2.6) degrees that was significantly reduced compared with the preoperative, immediate postoperative kyphosis correction rate average(39.2±9.1)%; 12 to 54 months of follow-up, an average of about 25 months, at the time of the last follow-up Cobb angle was(10±3.4) degrees compared with the preoperative obviously decreases, the correction loss rate was(13.3 ±27.7)%; within a week after operation the JOA score was(11.31±1.04) points at the last follow-up, the JOA score was(15.04±1.76)%, compared with that before operation were significantly improved at the last follow-up, the improvement rate was(76.3±20.1)%.Conclusion: The anterior approach and the posterior approach are effectivemethods for treating cervical deformity. Anterior approach with posterior cervical kyphosis correction surgery with shorter operation time, less hospitalization time, less bleeding.