Comparison Cervical Curvature And Clinical Efficacy Of Two Anterior Cervical Methods In The Treatment Of Two-level Adjacent Cervical Spondylosis

PURPOSE:To compare cervical curvature effect and the clinical curative effect by vertebral body subtotal resection decompression bone graft Fusion(Anterior Cervical Corpectomy and Fusion,ACCF)and the intervertebral disc decompression and interbody Fusion(Anterior Cervical Discectomy and Fusion,ACDF)in patients with2-level adjacent Cervical intervertebral disc herniation,Provide a reference for such patients.METHODS:47cases accepted anterior cervical spine surgery were selected in China-Japan Union Hospital of Jilin Universiy from 2013 to 2016,among these cases 25 patients underwent the anterior cervical corpectomy and fusion(Group A)and 22 patients accepted the anterior cervical discectomy and fusion(Group B).Two groups of patients with imaging data suggests spinal cord or nerve root pressure and confirmed that there is a clear oppression and a corresponding signs.All the patients received at least 6months of strictly conservative treatment and the symptoms were not relieved before the operation.To compare the two groups of patients aspect of the segmental-related curvature、Total cervical curvature(D numerical value)、C2-7Cobb angle,JOA score.Preoperative and postoperative average data were recorded to compare the operative effect and difference on cervical curvature.RESULTS:The two groups of patients were received effect follow-up,,the average follow-up time was 15 months.Group B was less than group A on the bleeding volume and hospital stays All patients received satisfactory therapeutic effects and JOA score,JOA score of 1 week,3 months and the last follow-up all have statistical significance in two groups(P<0.05),but there was no statistically significant in allperiods between two groups(P>0.05).Two groups 3months and the last follow-up found that C2-7 Cobb Angle of group B was better than group A(t = 3.161,P= 0.003).CONCLUSION:The most important thing is to master surgical indications in treatment of adjacent two-level cervical spondylosis,The different treatments of Anterior Cervical Corpectomy and Fusion(ACCF)and Anterior Cervical Discectomy and Fusion(ACDF)for adjacent two-level cervical spondylosis can achieve good therapeutic effect;AACF and ACDF surgery methods in maintaining cervical curvature and fusional segment curvature have no obvious differences,But as time goes on C2-7 Cobb angle in group ACCF was significantly lower than group ACDF.Two methods of surgery can cause different degree.