Different surgical approaches and their clinical efficacy in elderly patients with multi-level cervical spondylosis
10.3760/cma.j.issn.0254-9026.2015.11.007
- VernacularTitle:老年多节段颈椎病患者的手术方案选择及疗效分析
- Author:
Xiaosheng MA
;
Yunzhi GUAN
;
Shuo YANG
;
Jianyuan JIANG
;
Feizhou LYU
;
Xinlei XIA
;
Hongli WANG
- Publication Type:Journal Article
- Keywords:
Cervical spondylosis;
Spinal fusion;
Verterbroplasty
- From:
Chinese Journal of Geriatrics
2015;34(11):1174-1177
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical effect of different surgical approaches on multi-level cervical spondylosis in elderly patients.Methods A total of 53 aged patients with multi-level cervical spondylosis (≥70 years old) who received operation in our department during May 2007 to May 2014 were retrospectively studied, and divided into anterior cervical surgical group (n=22) and posterior cervical group (n=31), according to the surgical approach.The operation duration, intraoperative blood loss, hospitalization time, postoperative complications, Japanese orthopedics association (JOA) scores, Neck disability index (NDI), postoperative subjective improvement of clinical symptoms and spinal fusion of the two groups were evaluated and compared respectively.Results The mean operative time was longer in the anterior surgical group than in the posterior surgical group [(2.7±0.5)h vs.(1.9±0.3) h, P＜0.05].The average blood loss of the anterior surgical group was less than that of posterior surgical group [(90.0±50.4) ml vs.(160.7±40.5)ml, P＜0.05].The hospitalization time of the anterior surgical group was less than that of posterior surgical group [(10.3±2.5) d vs.(15.7±3.6) d, P＜0.05].Postoperative JOA score of anterior surgical group was higher than that of posterior surgical group 6 months after surgery [(14.7 ±0.8)vs.(13.8±1.2), P＜0.05], while there was no significant difference in JOA score between the two groups up to the last follow-up [(14.8±1.2) vs.(14.7±1.8), P＞0.05].NDI score was lower in anterior surgical group than in posterior surgical group 3, 6, 12 months after operation and at the last follow-up.Among the 41 patients, radiographic outcomes showed that there were 16 cases of anterior surgical group with no bony fusion at the follow-up 3 months after operation, and all the 16 patients achieved bony fusion at the follow-up 1 year after operation, and there were 4 cases with titanium mesh subsidence (＜ 3 mm).Conclusions Both anterior cervical decompression and fusion and posterior cervical single open-door laminoplasty have good efficacy in the treatment of multilevel cervical spondylosis in elderly patients, which have advantages on the limb functional recovery time and cervical function assessment.When anterior cervical surgical contraindications were excluded, the anterior cervical decompression and fusion may be a good choice for the treatment of multilevel cervical spondylosis in aged patients.
