Medium-term Analysis Of The Effect Of Cervical Anterior Disc Replacement On The Degeneration Of Segment Adjacent Vertebral

Objective: To learn data through the collection of patients with cervical anterior disc replacement in more than 3 years of clinical and imaging follow-up,statistical analysis and imaging measurement,contrast and decompression and fusion for patients with cervical disc surgery,to explore the middle cervical arerior disc replacement on the degeneration of segment adjacent vertebral effect.Methods: Patients admitted from October 2011 to December 2014 and screened according to Wannan Medical College Yijishan Hospital spine surgery department requiring cervical operation of 46 patients,including 24 cases of cervical anterior disc replacement operation,22 cases underwent anterior cervical discectomy and fusion.The clinical efficacy of two groups was evaluated by analyzing the data of the neck disability index(NDI),the Japanese orthopedics Association treatment(JOA)and the visual analog score(VAS)within preoperative,1 years after the operation and 3 years after the operation.The degeneration of segment adjacent vertebral within preoperative and final follow-up were measured by X-ray to measure the cervical curvature and adjacent segment activity,and the Kellgren grading standards was used to evaluate the degeneration of adjacent segments.Conclusion: The NDI scores of the patients in group CADR and group ACDF were significantly lower than those before the operation.In the 1 year after operation,the JOA score in group CADR was 15.23±3.27,and that in group ACDF was 15.74±3.42.There was no significant difference between the two groups(P>0.05).In the 3year after operation,the JOA score in group CADR was 7.42±1.04,and that in group ACDF was 7.83± 1.54.There was no significant difference between the two groups(P>0.05).The JOA scores in group CADR and group ACDF were significantly higher than those before operation.In the 1 years after surgery,CADR group,JOA score was12.48 ± 1.44,ACDF group was 12.04 ± 1.49,there was no significant difference between the two groups(P>0.05).After 3 years,the CADR group JOA score was 15.29± 1.82,ACDF group is 14.93 ± 1.25 points,no statistically significant difference between the two between the groups(P>0.05).The VAS scores in group CADR and group ACDF were significantly lower than those before operation.In the 1 years after operation,the VAS score of group CADR was 3.14±1.47,and the ACDF group was2.89±1.15 points.There was no significant difference between the two groups(P>0.05).After 3 years,the VAS score of group CADR was 1.91±0.48 points,and the ACDF group was 1.99 ± 0.57 points.There was no significant difference between the two groups(P>0.05).CADR group and ACDF group of two groups of patients before and at the end of the follow-up C2-7Cobb angle and surgery adjacent upper and lower segments of the activity have different degrees of change,CADR group activity had no significant difference(P>0.05),there is difference between the ACDF group and the group activity was statistically significant(P<0.05).According to the evaluation results of Kellgren X-ray disc grading,3 cases of adjacent segment degeneration occurred in group CADR,of which 1 cases were degenerated from grade 0 to 1 grade,1 cases were degenerated from 0 to 2,1 cases were aggravated from 1 to 3,and the rate of degeneration was 12.5%.In group ACDF,there were 5 cases of adjacent segment degeneration,including 2 from 0 to 1,2 from 0 to 2,1 from 1 to 3,and the rate of degeneration was 22.7%.