Influence Of Cervical Disc Arthroplasty And Anterior Cervical Decompression And Fusion On Adjacent Segment Degeneration

Objective Compare curative effect and adjacent segment degeneration after CervicalDisc Arthroplasty and Anterior cervical decompression and fusion.Methods Between August2009and October2012. There were66cases withsingle segmental cervical disc degeneration disease In the Department oforthopedics, General Hospital of Ningxia Medical University. randomly divided into34patents received CDA and32patents received ACDF,The neck disability index (NDI) andJOA to evaluate clinical efficacy of two groups after operation, Adjacent segmentdegeneration was evaluated on X-ray and magnetic resonance imaging（MRI）. Cervical discdegeneration was evaluated according to Kellgren′s grading system based on X-RAY andMiyazaki′s grading system based on T2-weighted MRI.Results Follow-up time of19-50months, mean34months. NDI of ACDF group38.37±5.32preoperatively improved to6.31±5.61, JOA improvement rate was75.6%; NDI ofCDA group improved from37.75±5.94to2.85±2.66, JOA improvement rate was80.4%.Rom of Adjacent segment： there were no change significantly. Kellgren′sgrading：there were10segments evaluated as degeneration in ACDF group last follow-up(incidence18.5%);7segments in CDA group (incidence of14.6%), there was no significantdifference between the two groups, there were21segments evaluated as degeneration inACDF group last follow-up with Miyazaki，and13segments in CDA group，there was nosignificant difference between the two groups. .Conclusions ACDF group was higher than CDA group comparis on adjacent segmentdegeneration by X-ray and MRI during follow-up, but there was no significant differencebetween the two groups, CDA did not significantly slow down the degeneration of adjacentsegment disc.