Curative Comparison Of Anterior Cervical Corpectomy Decompression Titanium Mesh Bone Graft And Nano Hydroxyapatite/Polyamide 66 In The Treatment Of Single Segment Cervical Spondylotic Myelopathy

Objective: To compare the anterior cervical corpectomy decompression titanium mesh bone graft and nano hydroxyapatite / polyamide 66 in the treatment curative of single segment cervical spondylotic myelopathy.Methods: Choosing 80 cases of single segment cervical spondylotic myelopathy from October 2011 to October 2014 in our hospital orthopedic(spine group),depended on the surgical treatment,setted the anterior cervical corpectomy decompression titanium mesh bone graft to treatment group ?(40 cases),nano-hydroxyapatite / polyamide 66 interbody fixation artificial treatment to treatment group ?(40 cases),recorded the operative time,blood loss,postoperative complications,combined with the immediate postoperative and postoperative cervical standards 3,6,12 months and had held out curved lateral X-ray,patient assessment and patient records The cervical curvature(Cobb angle,D value),intervertebral height(fusion of vertebral height-HAB,fused posterior edge height-HPB),fusion,implant subsidence,neurological improvement(JOA score),etc.,then underwent statistical analysis.Results: The operative time and blood loss were approaching(t=2.114,P>0.05;t=1.957,P>0.05)in the two group;To October 31,2015,40 patients were reviewed by the clinic or telephone methods were followed up(12-39)months,with a median follow-up time of 25 months;The postoperative nerve function were significantly improved,but immediately after,after three months,after six month,12 months after neurological improvement rate is very(t=1.336,P>0.05;t=1.524,P>0.05;t=1.447,P>0.05;t=1.049,P>0.05);two groups of patients(Immediately after preoperative)D value difference the difference was not statistically significant(t=1.446,P>0.05);treatment ? group(after three months and immediately after),(after 6 months and After 3 months)(12 months after the difference after 6 months)D values were less than treatment ? group(t=4.557,P<0.05;t=4.259,P<0.05;t=5.331,P<0.05);two groups of patients(immediate postoperative and preoperative)Cobb angle difference was not statistically significant difference(t=2.559,P>0.05);treatment ? group(after three months and after immediately),(after 6 months and after three months)Cobb angle is less than the difference between the treatment group ?(t=6.884,P<0.05;t=6.147,P<0.05);two groups of patients(postoperative difference 12 months and after six months)Cobb angle difference was not statistically significant(t=2.847,P>0.05);two groups of patients(immediate postoperative and preoperative)HAB difference was not statistically significant difference(t=2.982,P>0.05);treatment ? group(after three months and immediately after),(after 6 months and after 3 months)(12 months after surgery and after 6 months)HAB is less than the difference between the treatment group ?(t=8.249,P<0.05;t=7.548,P<0.05;t=7.987,P<0.05);two groups of patients(immediate postoperative and preoperative)HPB the difference was not statistically significant difference(t=2.873,P>0.05);treatment ? group(after three months and immediately after),(after 6 months and after 3 months),(surgery after 12 months and after six months)HPB is less than the difference between the treatment group ?(t=8.564,P<0.05;t=7.127,P<0.05;t=8.014,P<0.05);treatment ? group and Postoperative treatment ? group 3 and 6 months of fusion rates were(90.00% vs70.00%),(100.00% vs80.00%)(?2=5.148,P<0.05;?2=5.568,P<0.05);postoperative treatment group ? 12 months fusion rate of 100.00 percent,with 95.00 percent of the treatment group ? close(?2=1.058,P>0.05);As follow-up date,the treatment group ?had two cases nonunion,within five cases of abnormal plant(loose,shift,fracture,subsidence),four cases of intractable pain axis,fusion of adjacent segment degeneration of five cases(adjacent disc herniation,osteophytes formation),treatment group ? had two case of screw loosening,four cases of intractable pain axis,two case near herniation;treatment group ? complication rate was 20.00%,significantly lower than the treatment group ? 40.00%(?2=7.556,P<0.05).Conclusion: The anterior cervical corpectomy decompression titanium mesh bone graft and nano hydroxyapatite / polyamide 66 bone graft were cervical myelopathy effective treatment,but n-HA / PA66 artificial interbody cervical curvature and intervertebral height has recovered well,fusion rate,fewer complications,and other advantages,can be considered for replication.