Comparison Of Two Kinds Of Anterior Cervical Surgery For Treatment Of Short Term Therapeutic Effects Of Continuity Of Multilevel Cervical Spondylotic Myelopathy

Objective：To analyze the short term clinical effects of the treatment of Continuity ofmultilevel cervical spondylotic myelopathyby two methods of anterior cervicaldecompression and reconstruction.Method： retrospectively analysis39patient with continuous multilevel cervicalmyelopathy treated by the same team were divided into two groups:Anterior cervicalsingle corpectomy and discectomy titanium mesh combined with cage interbodyfusion and internal fixation with locking plate(Group I,21cases),Anterior cervicaltwo-segment-corpectomy and reconstructed with a long titanium mesh andplate(Group II,18cases)， The comparison between two groups in operation time,bleeding volume，The clinical curative effect（According to Odom standard），X-rayCobb’s angle，Changes in cervical physiological curvature（Preoperative, immediatepostoperative,3month after operation,6month after operation），Japanese Departmentof orthopedics association score system（JOA）classification method for spinal cordfunctional score(The improvement rate of spinal cord function RIS）and The rate ofbone fusion3and6months after operation.Result：The operation time of two groups had no statistical significance(P>0.05),Theamount of bleeding had significant difference(P<0.05),Two groups of nerve functionrecovery had no statistical significance(P>0.05), First groups of immediatepostoperative、3and6month after operation Cobb’s angle,cervical physiologicalcurvature,compared with preoperative had significant difference(P<0.05),Secondgroups of immediate postoperative、3and6month after operation Cobb’sangle,cervical physiological curvature,compared with preoperative had significantdifference(P<0.05),Between the two groups of immediate postoperative、3month afteroperation Cobb’s angle,cervical physiological curvature had no significant difference(P>0.05).6month after operation had significant difference(P<0.05).Twogroups of nerve function were improved,Improvement in JOA score of two groupsbefore and after operation had significant difference(P<0.05),Differences betweenthe two groups after operation had no statistical significance(P>0.05),The spinal cordfunction score of first group, the excellent and good rate was80.95%,The Secondgroup was83.33%,Two groups of nerve function recovery had no statisticalsignificance(P>0.05),First groups of3months after surgery, bone graft fusion rate was100%,Second groups was88.89%,6months after surgery was100%,The differencehad significant difference(P<0.05).The first group of1patients with loose screwscaused by operation incision infection.6months of follow-up no internal fixationlooseningafter surgery to remove. The second group of2cases with titanium meshshift,Among the1cases existence of titanium mesh is upwards and screw out In theimmediate postoperative period and6months after operation,Another1patientsimmediate postoperative after check cervical X-ray showed titanium net end slightlytilted,Because there are many complications in patients so no follow-up afterdischarge.Conclusion： Anterior cervical single corpectomy and discectomy titanium meshcombined with cage interbody fusion and internal fixation with locking plate forcervical spondylotic myelopathy can improve the anterior cervical fusioneffectively,Improve the cervical physiological curvature,Promote the recovery ofneurological function,Can reduce the incidence of postoperative complications suchas titanium mesh subsidence,Has a good application prospect.