Anterior cervical approach to expand longitudinal decompression range for treating cervical spondylotic myelopathy

doi:10.3969/j.issn.2095-4344.1202

Abstract

Abstract:

BACKGROUND: Cervical anterior decompression and fusion for treating cervical spondylotic myelopathy is regarded as a classic surgical method because of its exact curative effect, small intraoperative trauma and the decompression. This study expands the longitudinal decompression range based on the original classical procedure and compares it with the clinical efficacy of the classic procedure.

OBJECTIVE: To analyze the clinical efficacy of two different methods of anterior cervical decompression for treating cervical spondylotic myelopathy.

METHODS: One hundred and twenty patients were randomly divided into two groups A (traditional anterior cervical decompression) and B (expansion of the longitudinal decompression range of the anterior cervical spine) (n=60/group). Informed consents were obtained from all patients, and the trial was approved by the Ethics Committee of the Fourth Affiliated Hospital of Harbin Medical University. All patients were followed up for 1 year. The intraoperative and postoperative blood loss, Japanese Orthopaedic Association score, cervical curvature index, cervical flexion and extension activity, intervertebral bone graft healing time and fusion rate were compared to assess the clinical efficacy.

RESULTS AND CONCLUSION:(1) The intraoperative and postoperative blood loss in the group A was lower than that in group B (P < 0.05). (2) The recovery of neurological function (Japanese Orthopaedic Association score) in the group B was significantly better than that in the group A (P < 0.05). (3) There was no significant difference in the changes of cervical curvature index and range of motion between two groups (P > 0.05). (4) The postoperative healing time of intervertebral bone graft in the group B was significantly shorter than that in the group A (P < 0.05). There was no significant difference in the fusion rate between two groups (P > 0.05). (5) In summary, both surgical procedures can achieve good clinical results in the treatment of different degrees of cervical spine. The classic cervical anterior approach has little trauma during operation, and patients have certain advantages in postoperative bed-lifting activities. There is no significant difference in the recovery of cervical curvature and the rate of interbody fusion between two methods. The expansion of the longitudinal decompression range of the anterior cervical spine holds certain advantages in the neurological function of cervical spondylotic myelopathy and the healing time of intervertebral bone grafting.

Key words: anterior cervical approach, cervical anterior decompression, cervical spondylotic myelopathy, spinal cord injury, intervertebral bone graft healing time, intervertebral bone graft fusion rate, decompression range

CLC Number:

R459.9

Li Mi, Zhao Chengbin, Zhang Hanjun, Li Huazhe, Zhang Rui . Anterior cervical approach to expand longitudinal decompression range for treating cervical spondylotic myelopathy [J]. Chinese Journal of Tissue Engineering Research, 2019, 23(16): 2473-2478.

Figures/Tables 3

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