| Objective:To investigate the short-term effects of anterior cervical discectomy and fusion(ACDF)and artificial cervical disc replacement(ACDR)in patients with unilateral single-segment cervical spondylitis radiculopathy,and draw corresponding conclusions to provide guidance for future clinical work research data on medical evidence.Methods:From January 2013 to October 2017,a retrospective analysis of a total of 46 patients with unilateral single-segment cervical spondylitis radiculopathy who met the inclusion criteria underwent surgical treatment.All patient surgeries were performed by the same surgeon,including anterior cervical discectomy and fusion(ACDF)in 29 cases,and 17 cases underwent artificial cervical disc replacement(ACDR).Cervical spine dysfunction was evaluated by NDI questionnaire.Comparative clinical parameters include duration of preoperative symptoms,duration of surgery,and length of hospital stay after surgery;3 months,6 months,1 year,and 2 years of neck and upper limb pain visual analog scale(VAS)before and after surgery,and neck function Disability Index(NDI);patient satisfaction based on modified Odom’s criteria 2 years after surgery;surgical complications.Contrast imaging radiology parameters include segmental angulation(SA)and range of motion(S-ROM),cervical angulation(CA)and range of motion(C-ROM),intervertebral disc height(DH)of the surgical segment,and range of motion of adjacent upper and lower segments(U-ROM,L-ROM).Results:In the patients with ACDR and ACDF,postoperative neck and upper limb pain VAS and NDI were significantly lower than those before surgery,and the abovementioned indicators at all stages of postoperative examination were significantly reduced,and the difference was statistically significant P=0.000.There was no statistical difference between the two groups before and after each stage of p>0.05.In terms of postoperative patient satisfaction rate based on Odom’s criteria,there was no statistically significant difference in the superiority of the surgical effect between the ACDR group and ACDF(p>0.05).For the analysis of surgical complications,compared with the ACDF group,the incidence of complications was higher in the ACDR group,but there was no statistical difference p>0.05.The height of the intervertebral space in the ACDR group and the ACDF group was significantly higher at 1 and 2 years after surgery than before the operation,and the difference was statistically significant p<0.05.There was no statistical difference between the two groups before surgery,1 year after surgery,and 2 years after surgery.In terms of curvature of the surgical segment,there was a statistically significant difference between the 1 and 2 years postoperatively in the ACDR group compared with preoperatively;p<0.05;in the ACDF group,there was no statistical difference between the 1 and 2 years postoperatively.>0.05.There was no statistical difference between the two groups before and after 2 years of p>0.05,and there was a statistical difference of 1 year after operation p<0.05.In the ACDR group,the range of motion of the surgical segment increased 1 year after the operation but there was no statistical difference p>0.05,and 2 years after the operation increased statistically with a difference p<0.05;in the ACDF group,There was no statistical difference between 1 year and 2 years before operation p>0.05.There was no statistical difference between the two groups before operation and 1 year after operation p>0.05,and there was a statistical difference between 2 years after operation p=0.038.The angle of curvature of the whole cervical spine in the ACDR group increased 1 year and 2 years after surgery but there was no statistical difference p>0.05;in the ACDF group,the 1 year and 2 years after surgery decreased compared with before surgery but There was no statistical difference p>0.05;there was no statistical difference between the two groups before and 1 year and 2 years after operation.Total cervical spine motion range,in the ACDR group,there was an increase at 1 year and 2 years after operation but there was no statistical difference p>0.05;in the ACDF group,it decreased at 1 year and 2 years after operation compared with before surgery There were statistically significant differences p<0.05;there was no statistical difference in the range of total cervical motion before surgery between the two groups p>0.05;there was a statistical difference between 1 and 2 years after surgery p<0.05.In terms of the range of motion of the upper and lower adjacent segments,there was no statistical difference between the ACDR group and the ACDF group at 1 year and 2 years after operation compared with the preoperative condition,p>0.05;the comparison between the two groups,preoperative and postoperative There was no statistical difference between 1 and 2 years p>0.05.Conclusion:1.ACDF and ACDR two different surgical methods significantly improve the symptoms of patients with unilateral and single-segment cervical spondylitis radiculopathy,and the treatment is effective,but there is no difference in the treatment effect of the two surgical methods;2.There was a significant increase in both surgical methods compared to before surgery about disc height of surgical segment,but there was no difference between the two surgical methods;3.The ACDR group can better retain the surgical segment and full cervical spine range of motion,and can better maintain the curvature angle of the diseased segment;4.During the observed followup period,there was no difference in the influence of the two surgical methods on the activity of the upper and lower adjacent segments. |
PDF Full Text Request