Comparison of Three Different Surgical Methods in the Treatment of Cervical Spondylotic Myelopathy

Abstract

The course of cervical spondylotic myelopathy is slow, the surgical treatment is difficult and the effect is general, and it is easy to cause the decline of patient’s quality of life, even death. The aim of this study was to compare the efficacy of anterior, posterior and combined approaches in the treatment of cervical spondylotic myelopathy. A total of 105 cervical spondylotic myelopathy patients were selected from orthopedics department of our hospital from January 2016 to March 2019 according to the diagnosis and exclusion criteria. All patients were divided into the former group (n=36 cases), the latter group (n=34 cases) and the combined group (n=35 cases). After 3-12 mo of follow-up, Japanese Orthopaedic Association score was observed and the expression of interleukin 6, interleukin 8 and Tumor Necrosis Factor-alpha were detected. There was no significant difference in age, gender, course of disease, number of intervertebral space involvement and level of inflammatory factors among the three groups. The effective rate of the combined group was 91.4 %, which was significantly higher than that of the anterior group (66.7 %) and of the posterior group (67.6 %). After 3-12 mo of follow-up, we found that the Japanese Orthopaedic Association scores of the three groups were improved at 3, 6 and 12 mo after operation, and the improvement degree was positively correlated with the follow-up time, but the efficacy of the combined group was significantly better than that of the former group and the latter group. In addition, we found that the expression of Tumor Necrosis Factor-alpha, interleukin 6 and interleukin 8 in the three groups were significantly reduced at 3 mo after operation, and the level of Tumor Necrosis Factor-alpha, interleukin 6 and interleukin 8 in the combined treatment group was more significantly lower than that in the former and the latter two groups. The combination of anterior and posterior cervical surgery for cervical spondylotic myelopathy could achieve better therapeutic effect, recover and maintain the physiological radian of cervical spine, and effectively reduce the level of serum inflammatory cytokines in patients with cervical spondylotic myelopathy.