Comparison Of ACCF And ACDF In The Treatment Of Adjacent Two-segment Cervical Spondylosis And The Results Of Midterm Follow-up

Objective: To compare and compare the two methods of anterior cervical corpectomy and anterior cervical discectomy and fusion(ACCF)and anterior cervical discectomy and anterior cervical discectomy and fusion fusion(ACDF)for the treatment of adjacent two-segment spinal cord cervical spondylosis and the mid-term changes in sagittal parameters of the cervical spine.Methods: A retrospective analysis of clinical data of 86 patients with spinal surgery in the first affiliated hospital of Xinjiang Medical University from September 2013 to September 2016 who underwent anterior decompression and bone graft fusion and internal fixation for cervical spinal cord disease of adjacent two segments,According to the operation,they were divided into 41 cases in ACCF group and 45 cases in ACDF group.The surgical time,bleeding volume,preoperative and postoperative Japanese orthopaedic association(JOA)scores,and cervical disability index(NDI)were compared between the two groups.In June and the last follow-up,C2-C7 Cobb angle,C2-C7 SVA(sagittal vertical axis,SVA)and other cervical sagittal parameters.Results:There was no significant difference in the operation time and intraoperative blood loss between the two groups of patients(P<0.05).At the last follow-up,the NDI index and JOA score of the ACCF group were(7.00±1.03)and(16.32±0.52)points,respectively.The scores before(21.1±2.32)and(9.46±2.06)were significantly improved;the NDI index and JOA score of the ACDF group were(6.91±1.08)and(16.27±0.54)points,respectively,compared with(21.7±1.83)and(8.84±0.95)points significantly improved.There was no significant difference between the preoperative and final follow-up groups.At the last follow-up,the C2-C7 Cobb angle and C2-C7 SVA of patients in the ACCF group were(7.00±1.03)°and(16.32±0.52)mm,which were significantly improved compared to(19.22±2.71)°and(17.93±5.42)mmbefore surgery;The C2-C7 Cobb angle and C2-C7 SVA of the ACDF group were(6.91±1.08)° and(16.27 ± 0.54)mm,respectively,which were significantly improved compared with(19.80 ± 1.96)° and(17.09±4.00)mm before surgery.There was no significant difference between the two groups.Conclusion: In the treatment of adjacent two-segment spinal cord cervical spondylosis,the indications of ACCF and ACDF surgery must be strictly and flexibly grasped in order to be effective,and both surgical methods can improve cervical sagittal balance.