Comparison Of Curative Effect On Multilevel Cervical Spondylotic Myelopathy Between Expansive Z-type And The Single Open-door Laminoplasty

Objective:To analyze and compare the clinical effects on Multilevel Cervical Spondylotic Myelopathy between expansive Z-type laminoplasty and the single open-door laminoplasty.This study provides a theoretical basis for the safety and reliability of Z-type laminoplasty in actual clinical application.Methods:Collecting 60 cases of Multilevel Cervical Spondylotic Myelopathy by lumbar degeneration in our hospital from January 2016 to December 2019.According to different surgical methods,they were divided into expansive Z-type laminoplasty group(Z group,31 cases)and single open-door laminoplasty(Single group,29 cases).The age,the gender,operation tine,intraoperative blood loss,and cost of surgery were compared between the two groups.The follow-up data were analyzed by the japanese Orthopaedic Assocoation Scores(JOA score.The preoperative and final follow-up X-ray examination data of the groups were analyzed,measuring Range of motion(ROM)and Kyphotic deformity.The incidence of postoperative complications,Axial symptom(AS),Spring-back,C5 palsy,and Kyphotic deformity were compared between the Z group and the Single group of patients.Results:1.There were no significant differences in age,the gender and intraoperative blood loss between the Z group and the Single group(P>0.05),there were significant differences in the operation time and cost of surgery between the Z group and the Single group(P<0.001).2.JOA score of the Z group and the Single group were significantly changed before preoperative and final follow-up(P<0.001),there were no significant diference between the Z group and the Single group before and final follow(P>0.05).3.There was no significant differences in ROM between the Z group and the Single group before and final follow(P>0.05),there was significant differences in ROM between the Z group and the Single group final follow(P<0.05).4.There were no significant differences in the incidence of postoperative axial symptom(AS),spring-back and C5 palsy between the Z group and the Single group(P>0.05),there was significant differences in the incidence of postoperative kyphotic deformity betweenthe Z group and the Single group(P<0.05).Conclusion:1.Expansive Z-type laminoplasty can be used in the treatment of Multilevel Cervical Spondylotic Myelopathy,both postoperative neurological functions can be satisfactorily improved.2.The single open-door laminoplasty has certain advantages in shortening the operation time but expansive Z-type laminoplasty has an advantage in reducing the incidence of shortening cost of surgery,ROM and kyphotic deformity.3.Expansive Z-type laminoplasty has high safety and feasibility for Multilevel Cervical Spondylotic Myelopathy,the early curative effect is satisfactory and werthy of promotion.