A Comparative Research Of Two Anterior Decompression And Restruction For Treating2-level Cervical Spondylotic Myelopathy

Objective: Through retrospective study, To compare the short-term radiological dataand clinical outcomes of anterior cervical discectomy and interbody constructioncombined with PEEK-cage, Allogenic bone graft and anterior locking plate fixation(ACDF+PEEK Cage+Allogenic bone graft+anterior locking plate) and anteriorcervical corpectomy and interbody reconstruction combined with titanium mesh,Autogenic bone graft and anterior locking plate fixation (ACCF+Titanium mesh+Autogenic bone graft+anterior locking plate) for adjacent2-level cervical spondyloticmyelopathy.Method:49diagnosed patients with adjacent2-level cervical spondyloticmyelopathy(CSM) underwent surgical procedure treatment, from August2008toAugust2011,at Hospital in Guang Zhou general hospital of PLA were included andrespectively divided into group A and group B.20cases in group A were treated byanterior cervical discectomy and interbody construction combined with PEEK-cage,Allogenic bone graft and anterior locking plate fixation, while29cases in group Btreated anterior cervical corpectomy and interbody reconstruction combined withtitanium mesh, Autogenic bone graft and anterior locking plate fixation. All the twogroups were followed up for6to30months, average8.69±6.094months. Clinicaloutcomes were assessed pre-and postoperatively on the Japanese Orthopedic Association Scores (JOA score). All data, including operation time, intraoperativeblood loss, postsurgery hospital stay and the pre/post-operation radiologic parameters(total cervical curvature, segmental-related curvature, segmental–related cervicalheight, the incidence of instruments-related complications), recorded and analyzed tocompare the two groups.Result: postoperative JOA score improved obviously in both group. At final followup, all the patients developed bony fusion. The differences of the two groups,Thesurgical time (t＝-2.807，P＝0.007), bleeding loss (t＝-2.072，P＝0.044),segmental-related curvature (group A：t=-10.09,p<0.01；group B: t=-11.47,p<0.01)segmental–related cervical height （t=2.37,p=0.022） and the subsidence ofinstruments-related complications, were statistically significant, However, Thedifferences of other included parameters between the two groups were not statisticallysignificant.Conclusion: Within6to30months follow-up, the reliable clinical effectiveness ofthe both surgical protocols appears similar in adjacent2-level CSM, However, theavailable evidences, lower incidences of intra/post-operation complications provesACDF+PEEK Cage+Allogenic bone graft+anterior locking plate fixation may bemore rational and superior.