Clinic Study Of Relative Factors Affecting The Operative Effect Of ACDF For Cervical Spondylotic Myelopathy

Objective: To study the relationship between the curative effect of anteriorcervical decompression and interbody fusion for cervical spondylotic myelopathy and patient's gender , patient's age , disease course , degree of spinal cord pathology , fusion segment, postoperative cervical intervertebral height, postoperative cervical curve , and establish a multiple linear regression equation to offer the refer of the treatment of cervical spondylotic myelopathy .Method: According to inclusion criteria and exclusion criteria , 87 patients with cervical spondylotic myelopathy underwent anterior cervical decompression and fusion in 1st and 4th affiliated hospital of Jinan University from March 2000 to June 2004 . Eighty-seven lateral X-ray films of cervical spine, including the preoperative and one-week postoperative, three-month postoperative, six-month postoperative and tewleve- month postoperative were measured. Acording to Japanese Orthopaedics Association 17 scores method for the cervical spondylotic myelopathy, the neurological function was evaluated respectively . By single factor and multiple linear regression analysis , the relative factors were screened and the contribution of the factors were compared , a multiple linear regression equation was established .Result: The curative effect had relationship with patient's age and disease course . The effects of patients involved one or two inervertebral discs had no difference each other , but both their effects were significantly better than those of the three intervertebral discs involved . The height of anterior intervertebral , the height of posterior intervertebral and the cervical curve ( D numerical value ) of thepostoperative cases were obviously higher than that of the preoperative ( P<0.01 ) . The height of anterior intervertebral , fusion segment, disease course , patient's age are the important factors impacting operative results . The equation was : Y=62.157-2.461Xi-2.27X2-2.845X3+3.614X4.Conclusion: The height of anterior intervertebral increase rate , fusionsegment , disease course , degree of spinal cord pathology , patient's age are the affecting factors of the postoperative functional improvement rate by cervical anterior decompression and interbody fusion . The operartive should be performed as soon as possible when CSM is diagnosed exactly, and the effective decompression , height of fusion segment and internal fixation play important role in ACDF.