Two Different Posterior Surgical Methods For Treating Multi-segmental Cervical Spondylotic Myelopathy Comparison Of Curative Effect And Imaging Prognosis

Objective:In the treatment of multi-segmental cervical spondylotic myelopathy,the clinical effect and imaging parameters were compared with the classic posterior open-door laminoplasty,which is a new type of full-thoracic posterior spinal canal enlargement.The theory provides a theoretical basis for the safety and feasibility of the actual clinical application.Methods:In this study,a small sample prospective randomized controlled trial was conducted according to the actual situation.Patients who were diagnosed as multi-stage cervical spondylotic myelopathy from the Department of Spinal Surgery,Second Hospital of Shanxi Medical University in the same period of time were randomly divided into two groups.Patients who underwent new full-thoracic posterior vertebral canal angioplasty were enrolled in group A.Patients who underwent posterior single-door laminoplasty were labeled as group B.The operation time and bleeding volume of the two groups of patients were performed.Postoperative complications were recorded and compared between groups.The visual analogue scale(VAS)was applied to the evaluation of neck and upper extremity pain.The Japanese Orthopaedic Association(JOA)was used to evaluate cervical spinal cord function.The postoperative follow-up was based on patientimaging data.X-ray films,CT scans,and MRI examinations were performed to assess the position,stability,and spinal cord compression of the internal fixation after surgery.In imaging,the detailed data and changes of the median sagittal diameter and the cross-sectional area of the spinal canal were calculated and compared between the two groups of patients before and after surgery.Results:In terms of JOA scores,the postoperative scores of the two groups were significantly higher than those before the operation.The comparison between the two groups was statistically significant.The VAS scores were significantly lower in the two groups than in the preoperative scores.It is statistically significant.There was no significant difference between the JOA score and the VAS score between the A group and the B group.There was no significant difference in the incidence of postoperative axial symptoms between the A group and the B group.The operation time and bleeding volume existed in the two groups.Significant differences were statistically significant between the groups.The operation time of group B was shorter than that of group A,and the amount of bleeding in group A was more than that of group B.In group A,the degree of median sagittal diameter expansion and the extent of spinal canal enlargement were statistically significant compared with group B,and the former was larger.Conclusion:The new full-thoracic posterior vertebral canal angioplasty can be used in the treatment of multi-segment cervical spondylotic myelopathy,and satisfactory results can be obtained.Single-door surgery can also be performed.Both postoperative neurological functions can be satisfactorily improved.Single-door surgery has certain advantages in shortening the operation time and reducing the amount of surgical bleeding,but full laminar posterior spinal canal enlargement has an advantage in reducing the incidence of postoperative axial symptoms and expanding spinal canal volume.The wholelaminectomy is easy to operate,can fully enlarge the spinal canal,and has high safety and feasibility for the treatment of cervical spinal stenosis.The early curative effect is satisfactory and worthy of promotion.