The postoperative adjacent segment degeneration between the microscopically anterior cervical discectomy with fusion and anterior cervical corpectomy with fusion in the treatment of cervical spondylotic myelopathy and the influencing factors analysis of
10.3760/cma.j.cn115455-20220803-00693
- VernacularTitle:显微镜下前路椎间盘切除减压融合内固定术与前路椎体次全切除减压融合内固定术治疗脊髓型颈椎病术后邻近节段退变情况及影响因素分析
- Author:
Yi GE
1
;
Jiren QIU
;
Kunlie LUO
;
Yue WU
;
Fuchang WU
Author Information
1. 钦州市第二人民医院骨三科，钦州 535000
- Keywords:
Diskectomy;
Cervical spondylotic myelopathy;
Adjacent segment degeneration;
Risk factors
- From:
Chinese Journal of Postgraduates of Medicine
2023;46(8):740-744
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the postoperative adjacent segment degeneration (ASD) between the microscopically anterior cervical discectomy with fusion (ACDF) and anterior cervical corpectomy with fusion (ACCF) in the treatment of cervical spondylotic myelopathy and its influencing factors.Methods:Fifty patients with cervical spondylotic myelopathy treatment in the Qinzhou Second People′s Hospital from July 2018 to July 2020 were selected, they were divided into two groups, 25 patients performed ACDF (ACDF group), and 25 patients performed ACCF (ACCF group). The perioperative period, efficacy and incidence of ASD were compared between the two groups, and the influencing factors of ASD were analyzed.Results:The intraoperative blood loss, operation time, length of hospital stay and postoperative drainage in ACCF group were higher than those in ACDF group: (58.34 ± 8.61) ml vs. (46.77 ± 7.24) ml, (99.57 ± 10.72) min vs. (86.14 ± 9.64) min, (8.97 ± 1.43) d vs. (7.56 ± 1.24) d, (17.92 ± 2.95) ml vs. (14.28 ± 2.66) ml, there were statistical differences ( P<0.05). The postoperative Japanese Orthopaedic Association (JOA) scores and Neck Disability Index (NDI) scores in the two groups were improved significantly ( P<0.05), but the scores of JOA and NDI in the two groups had no significant differences ( P>0.05). The incidence of ASD in the two groups had no significant differences ( P>0.05). The Cox univariate analysis showed that age >59 years, intervertebral disc degeneration, number of fusion segments >2, osteoporosis and postoperative ASD were risk factors for ASD( P<0.05). Conclusions:The effect of microscopically ACDF is similar to that of ACCF in the treatment of cervical spondylotic myelopathy, but ACDF has the advantages of less trauma and quick recovery. The risk of postoperative ASD should be vigilant for patients with age >59 years old, intervertebral disc degeneration, number of fusion segments >2 or osteoporosis.
