| Objective: To compare the the advantages and disadvantages of interbody autograftiliac bone graft with anterior plate fixation and titanium mesh cage with anterior platefixation on treating Cervical Spondylotic Myelopathy, and to study the differences betweenthe two surgical methods on treatment result,restore intervertebral cervical curvature andheight and postoperative complications, so as to guide clinic application.Methods: The clinical data of37Patients (25males and12females, an average age of53.5) with cervical spondylotic myelopathy who underwent anterior cervicaldecompression fusion operative treatment between September2010and March2012inHospital Affilated to Shan Dong University of Traditional Chinese Medicine wereanalyzed retrospectively. There are18cases with intethody autograft iliacbone graft andanterior plate fixation and19cases with titanium mesh cage and anterior plate fixation,andthey were divided into two groups, A and B. Then made a statistical analysis of operationtime and amount of bleeding according to the clinical data of all patients, and comparedthem with the paired t test. A retrospective analysis about Preoperative and postoperativeJOA scores and the recovery rates were performed and evaluated in37patients. Thepreoperative, the last follow-up of anteroposterior and lateral X-ray plain films, Cobb anglemeasurement fusion segments of the lordosis (or kyphosis)，the value of the cervicallordosis(or kyphosis)D， the height of vertebral fusion segments between HAB and HPBof all Patients were performed and evaluated respectively. The paired t test was adopted tocompare the difference of parameters in each parameter. What’s more, the fusion rate andthe rate of post-operative complications were applied to perform statistical analysis.Results: All patients were followed up with an average of15.2months (range12-18 months). There were significant differences between surgery time and blood loss insurgery(P<0.01), and the group B is lower than group A. The both groups in patients JOAscores were significantly better than before operation (P<0.05), so there was significantdifference. That’s showed the two kinds of operation methods both achieved effectiveprocedures in the treatment of the disease. The neurologic recovery rate was no significantdifference between the two groups (P>0.05). All patients’ conditions in3month and6month after surgery both were compared with conditions preoperatively. Two groups ofheight of Vertebral fusion segments of HPB and Cobb angle had significantdifference(P<0.01). Otherwise, There was no difference between the value of the cervicallordosis(or kyphosis) D and the height of HAB in two groups after operation(P>0.05).Group A’s fusion rate was94.4%at3months after surgery, and Group B’s was94.7%. Thetwo groups were both bone fusion at6months post operation. There was no significantdifference between the two groups (P>0.05). Different extents of complications wereoccurred postoperatively in two groups. The rate of post-operative complications of GroupA was50.0%and Group B was42.1%, so the autograft iliac bone group had a slightlyhigher probability than titanium mesh group. There was obvious difference between twogroups (P<0.05).Conclusion: Both the titanium mesh and autograft iliac bone groups have aehievedgood results in the treatment of cervical spondylotic myelopathy. The titanium mesh grouphad shorter surgery time and less blood loss in surgery than autograft iliac bone group.There is no difference in maintaining the curvature of cervical spine and the height ofvertebral fusion segments between HAB. But the titanium mesh group in the maintenanceof fusion segments vertebral height HPB and lordosis of the Cobb angle is superior toautograft iliac bone group. There was no significant difference between the titanium meshgroup and autograft iliac bone group in fusion rate.The rate of post-operativecomplications of titanium mesh group was lower than autograft iliac bone group. |
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