Long-term Follow-up Study On The Treatment Of Single-level Cervical Spondylosis Through Intervertebral Disc Replacement And Anterior Cervical Decompression And Fusion

Objective:This study aims to compare the efficacy and safety of the postoperative long-term effect of the treatment of single-level cervical spondylosis through anterior cervical discectomy and fusion（ACDF）and artificial cervical disc replacement（ACDR）.Methods:A total of 113 patients are divided into two groups:ACDF group（n=66）and ACDR group（n=47）.The follow-up visit time was≥96 months.The evaluation index included the visual analogue scale,neck disability index,range of motion,dysphagia,adjacent vertebral disease and related complications（prosthesis displacement,heterotopic ossification,etc.）.Results:The VAS and NDI of these two groups of patients significantly improved,when compared with those before the operation.In the last follow-up visit,the range of motion in the replacement group and fusion group was 43.22±3.58 and 32.54±2.82,respectively,and both are significantly different（P<0.05）.The dysphagia incidence of the replacement group was higher than that of the fusion group at the 36^thmonth,but was lower than that of the fusion group in other point-in-time.In the last follow-up visit,six patients（12.77%）in the ACDR group and 18 patients（27.27%）in the ACDF suffered from adjacent segment degeneration.The general complication rate in the replacement group and fusion group was 38.31%and 37.88%,respectively,but the difference was not statistically significant（P>0.05）.Conclusion:Overall,the clinical efficacy and related complication rate of single-level cervical spondylosis after an anterior cervical approach operation was superior in the replacement group,when compared to the fusion group,during the eight-year follow-up,but the impact of age factor and the related biomechanics theory upon clinical prognosis still needs further research.