A Comparative Study On The Biomechanics And Clinical Efficacy Of Two Cervical Fusion Methods In The Treatment Of Degeneration Of Adjacent Segments Of Cervical Spondylopathy

Part1 A comparative analysis of two anterior cervical fusion method in the treatment of 2-level cervical spondylopathy Complicatio ns of adjacent segment intervertebral disc pressureObjective: With the advent of an aging society,cervical degenerative diseases affect more and more people.Anterior cervical discectomy and fusion(ACDF)is widely used in the bisection Treatment of segmental cervical spondylosis.A large number of studies have proved that the original Conventional cage-plate intervertebral fusion system(CCP)in the treatment of two-level cervical spondylosis after adjacent segment degeneration(ASD)The rate is high.For two-level cervical spondylosis,this study compared the two surgical methods of Zero-profile intervertebral fusion system(Zero-P)and CCP with biomechanical experiments.The role of intradiscal pressure in the upper segment of the vertebral body,and analyze the factors that affect the degeneration of the adjacent segment after anterior surgery.Methods: A total of 18 male adult goats were picked and randomly divided into 3 groups for C3-T1 cervical specimens,6 cases without any treatment(normal group),and 6 cases simulating CCP Group,6 cases simulating Zero-P group,CCP group and Zero-P group were divided into C5-7 two-level fusion.Test 3 groups of specimens under flexion,extension and axial rotation loading modes.Record the pressure value of the upper intervertebral disc(C4-5).Results: the CCP group and the Zero-P group,under the condition of flexion,extension and axial rotation,the pressure in the upper intervertebral disc was increased.under the condition of flexion,extension,the pressure in the disc of Zero-P group is lower than that of CCP group,Under the condition of axial rotation,no difference between the two groups.Conclusions: CCP group and Zero-P group increased intradiscal pre ssure in adjacent segments,under the condition of flexion,extension,the pressure in the disc of Zero-P group is lower than that of CCP group,Provides the possibility to delay the Adjacent segment degeneration.Part2 A comparative study on the curative effect of two anterior cervical spine surgical methods on the treatment of 2-level cervical spondylosisObjective: Compare the clinical effects of two surgical methods,Zero-P and CCP,in the treatment of 2-level cervical spondylosis.Methods: 63 patients underwent ACDF from January 2014 to September 2016 were selected as the study target,including 31 patients in the Zero-P group and 32 patients in the CCP group.There was no statistical difference in age,gender,JOA score,VAS score,NDI score,and surgical level between the two groups.Observe the clinical efficacy and incidence of dysphagia in two groups of patients,and review X-ray film,Observe the height of intervertebral space,curvature of cervical spine,and fusion of intervertebral space.Results: All patients recovered significantly,The JOA score,VAS score,and NDI score of the two groups were improved compared with preoperative(P<0.05).The height of the intervertebral space and the overall curvature of the cervical spine in the two groups were significantly improved compared with those before the operation(P<0.05),There was no statistically significant difference in postoperative surgical segment fusion between the two groups(P> 0.05);the incidence of dysphagia in the CCP group was higher than that in the Zero-P group(P <0.05).Conclusions:1.Zero-P and CCP have good clinical effects in the treatment of dual-segment cervical spondylosis,and there is no difference in imaging data.2.Zero-P cervical spine surgery,easy to operate,without the need for anterior plate,low incidence of postoperative dysphagia,no serious complications.Part3 A comparative study of the effects of two anterior cervical surgical methods on the treatment of cervical spondylosis of 2-level on the degeneration of adjacent segmentsObjective: Compare the influencing factors of postoperative ASD in the treatment of two-level cervical spondylosis with Zero-P and CCP.Methods: From January 2014 to October 2016,69 patients underwent ACDF as the study target,including 33 cases in the Zero-P group and 36 cases in the CCP group.Observe the JOA score and NDI score of the two groups,and review the X-ray film to measure the changes of SACS,SSA,ROM,SROM,IROM,and evaluate the degeneration of adjacent segments after two-level surgery.There were differences in ROM,SROM and IROM between the two groups after operation.The incidence of ASD in Zero-P group was lower than that in CCP.Results: Symptoms improved in two groups of patients;SACS and SSA in two groups were improved compared with preoperative,ROM in CCP group was lost compared with preoperative,SROM and IROM increased compared with preoperative(P<0.05);ROM,SROM and IROM values in Zero-P group Change is meaningless(P> 0.05).Conclusions:1.Zero-P and CCP can achieve satisfactory results in the treatment of dual-segment cervical spondylosis.2.Zero-P is rarely associated with ASD in patients with 2-level cervical spondylosis.3.Zero-P keeps the ROM,reduces the increase of SROM and IROM,and provides the possibility of delaying the occurrence of ASD.