Abstract：Objective To discuss the effect of elaborative decompression under microscope through anterior cervical approach in the treatment of cervical spondylotic myelopathy. Methods Clinical data of 70 cases of cervical spondylotic myelopathy in our hospital from January 2016 to May 2017 were retrospectively analysis. They were divided into microscopical group and open group. There were 35 patients with elaborative decompression under microscope through anterior cervical approach, 35 patients with traditional open cervical anterior decompression.The operative time, intraoperative blood loss, postoperative drainage volume, drainage tube retention time, hospital stay and postoperative complications between the two groups were compared. Before and after 1 month, 3 months, 6 months, 1 year points, the Japanese Orthopaedic Association (JOA) score, improvement rate and cervical disability index score were used to evaluate postoperative neurological function improvement. Results The operative time, intraoperative blood loss, intraoperative blood transfusion volume, postoperative drainage volume, drainage tube retention time, hospital stay in microscopical group were (75.13±11.06)min, (26.14±16.36)mL, (26.42±15.37)mL, (1.09±0.60)d and the operative time, intraoperative blood loss, intraoperative blood transfusion volume, postoperative drainage volume, drainage tube retention time in open group were (74.86±10.57)min, (45.36±18.05)mL, (51.23±16.42)mL, (1.11±0.58)d. The intraoperative blood loss, postoperative drainage volume, in microscopical group were lower than those in open group, and the differences were statistically significant (all P values＜0.01). The JOA score at 1 month, 3 months, 6 months after operation in microscopical group were higher than those in open group, and the differences were statistically significant (all P values＜0.01). There were no significant differences in JOA score before operation and 1 year after operation time points between the two groups (all P values＞0.05). The JOA score's improvement rate at 1 month and 3 months after operation in microscopical group were higher than those in open group(all P values＜0.01), but there were no significant differences at 6 months and 1 year after operation between the two groups(all P values＞0.05). The cervical disability index score at 1 month, 3 months, after operation in microscopical group were higher than those in open group, and the differences were statistically significant (all P values＜0.01). There were no significant differences in cervical disability index score before operation and 6 months, 1 year after operation points between the two groups (all P values＞0.05). Conclusions Compared with traditional open cervical anterior decompression, elaborative decompression under microscope through anterior cervical approach has the advantages of accurate decompression, less trauma, less bleeding, less pain and quick recovery after operation. It can significantly improve the postoperative neurological function, improve the quality of life, the curative effect is accurate. It worthy to be popularized and applied by domestic spinal surgeons in anterior approach surgery.
刘鹏飞, 张文志, 贺瑞, 李旭, 段丽群. 显微镜辅助下颈前路精细化减压治疗脊髓型颈椎病的临床研究[J]. 中华解剖与临床杂志, 2018, 23(3): 203-208.
Liu Pengfei, Zhang Wenzhi, He Rui, Li Xu, Duan Liqun. Clinical research of elaborative decompression under microscope through anterior cervical approach in the treatment of cervical spondylotic myelopathy. Chinese Journal of Anatomy and Clinics, 2018, 23(3): 203-208.
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