Clinical Comparative Analysis Between Anterior Cervical Microsurgery And Traditional Anterior Cervical Open Operation In The Treatment Of Cervical Spondylosis

Objective: By comparing with anterior cervical open operation under direct vision to explore the merits of anterior cervical microsurgical discectomy combined with cage and anterior locking titanium plate for cervical spondylosis.Methods: A total of 156 patients treated with anterior cervical microsurgical discectomy combined with cage and anterior locking titanium plate at Department of Orthopedics 3,the Affiliated Zhongshan Hospital of Dalian University between 2009 and 2016 were retrospectively analyzed.According to the operation,the patients were divided into group A(108 patients were treated with anterior cervical microsurgical discectomy combined with cage and anterior locking titanium plate)and group B(48 patients were treated with anterior cervical discectomy combined with cage and anterior locking titanium plate).(1)In order to clarify whether the two groups were comparable,the sex,age,body mass index(BMI),JOA score,neck and upper limb VAS score,NDI score,Cobb angle were compared between two groups of patients.(2)Comparison of the two groups of patients with skin incision,the operation time,amount of bleeding,incidence of complication and hospitalization time were evaluated whether there is a difference.(3)According to the clinical outcome before and after surgery,including scores of Japanese orthopaedic association(JOA 17 score method),visual analogue scale(VAS)of neck and upper extremities,neck disability index(NDI),imaging manifestations(including: disc space height and Cobb angle)and other indexes were evaluated the surgical results.Results:(1)No statistically significant differences were identified between the sex,age,body mass index(BMI),JOA score,neck and upper limb VAS score,NDI score,Cobb angle(P >0.05),the two groups were comparable.(2)In group A,the length of the incisionwas shorter,the operation time was shorter,the intraoperative bleeding was less,the complication rate was lower,and the length of the hospital was shorter than group B(P<0.05).(3)In two groups,compared with pre-operation,the postoperative JOA score,VAS score of neck and upper extremities,NDI score,disc space height and Cobb angle were markedly improved,with a significant difference(P<0.05).There was no significant difference between the two groups in postoperative JOA score,neck and upper limb VAS score,NDI score,imaging performance(including: disc space height and Cobb angle),no statistically significant differences were identified between group A and B(P>0.05).Conclusion: Both open operation under direct vision and microsurgery in anterior cervical spine surgery for treating cervical spondylosis achieved a good curative efficacy.Microsurgery achieved a better recent efficacy with shortened hospital stay,minimal tissue damage,less bleeding,small incision and a low incidence rate of postoperative complications.