| Backgroud: Anterior cervical decompression and fusion(ACDF)to treat cervical spondylosis resulted in loss of segmental mobility,surgery adjacent segment abnormal range increases and intervertebral disc degeneration and so on performance has become increasingly apparent.Many scholars began to explore the non-fusion technology to replace traditional arthrodesis,cervical artificial disc replacement(CDR)as a new type of non-fusion technology more and more applied to clinical,achieved good effect.But the longer duration of follow-up,its shortcomings also gradually exposed.At present the anterior cervical decompression and internal fixation and fusion effect of artificial disc replacement in the treatment of cervical spondylosis comparison has not been consistent conclusions.Objective: To compare the clinical effects of DISCOVER artificial disc replacement and anterior cervical discectomy and fusion in the treatment of cervical spondylosis.Methods:A total of 52 patients with cervical spondylosis,whose signs and symptoms were accorded,were enrolled from the Affiliated Hospital of Qingdao University from 2012 to 2015 to perform the retrospective analysis,imaging revealed that cervical disc degeneration compressed spinal cord or nerve root.Owing to different surgeries,these patients were divided into artificial disc replacement group(replacement group;n=26)and anterior cervical discectomy and fusion group(fusion group;n=26).They were followed up at instant?3?12?24 and 36 months after treatment.Japanese Orthopaedic Association scores(JOA)?Neck Disability Index(NDI)?Visual Analogue Scale(VAS)were measured and Cervical Curvature Index(CCI)?the range of motion of the replacement segment and the adjacent segments were observed to analyze.Results:All patients obtained the follow-up range from24 to 36 months.The postoperative Japanese Orthropaedic Association(JOA)Scores were improved compared with preoperative scores(P<0.05),the postoperative SF-36 scores were improved compared with preoperative scores(P<0.05),while the Visual Analogue Scale(VAS)scores were decreased compared with preoperative,the postoperative Neck Disability Index(NDI).There were no significant differences between two groups(P>0.05).The satisfactory rate of Odom's of replacement groups at 3?12 months and the final follow-up after operation were 92.3%?97.2%?97.2%,the satisfactory rate of Odom's of fusion groups at 3?12 months and the final follow-up after operation were 91.0%?95.4%?93.2%.The postoperative satisfactory rate of Odom's were improved compared with preoperative(P<0.05),There were no significant differences between two groups(P>0.05).Range ofmotion of the replacement segment after treatment was(8.00±0.11)° in the replacement group,showing no significant differences as compared with before surgery(8.04±1.06)°(P>0.05).No significant activity was found after treatment in the fusion group,significant differences compared with preoperative(P<0.05).The postoperative cervical total motion in replacement group was(43.37±5.25)°,no significant differences(P>0.05)compared with preoperative cervical total motion(45.68±5.34)°.The postoperative cervical total motion in fusion group was(38.96±4.26)°,significant differences(P<0.05)compared with preoperative cervical total motion(44.64±4.57)°.The Cervical Curvature Index(CCI)in replacement group at 3?12 months and final follow-up were no significant differences compared with preoperative(P>0.05),while in fusion group were significant differences compared with preoperative(P<0.05),and there were significant differences between two groups(P<0.05).The postoperative motion of upper adjacent segment at final follow-up in replacement group was(8.72±1.50)°compared with preoperative(8.48±1.61)°?lower adjacent segment was(8.26±1.34)°compared with preoperative(8.09±1.59)°.There were all no significant differences(P>0.05).The postoperative motion of upper adjacent segment at final follow-up in fusion group was(10.78±1.30)°compared with preoperative(8.50±1.97)°?lower adjacent segment was(9.03±1.26)°compared with preoperative(7.74±1.39)°.There were all significant differences(P<0.05).Conclusion:In improving clinical symptoms and restore nerve function,there is no significant difference between the anterior cervical decompression and fusion(ACDF)with DISCOVER cervical artificial disc replacement(CDR),and in terms of short-term follow-up,DISCOVERcervical artificial disc replacement(CDR)to maintain the segmental mobility,reduce adjacent segment disc degeneration and maintain cervical curvature has more advantages... |
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