Clinical research of elaborative decompression under microscope through anterior cervical approach in the treatment of cervical spondylotic myelopathy

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 0.05). 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 0.05). 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 0.05). 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. Key words: Cervical spondylosis; Myelopathy; Cervical anterior decompression; Microsurgery