Clinical And Radiologic Comparison Of Dynamic Cervical Implant Versus Anterior Cervical Diskectomy And Fusion For Single-level Cervical Degenerative Disc Disease

Objective:To evaluate clinical and radiologic outcome in patients treated with a dynamic cervical implant(DCI)or anterior cervical diskectomy and fusion(ACDF).The cervical spinal cord or cervical spondylotic myelopathy caused by single-level cervical degenerative disc disease.[Methods]60 patients with single-level cervical degenerative disc disease(DDD)admitted from March 2013 to August 2014 were divided into experimental group and control group according to their different surgical methods.The experimental group:DCI group(n=24),the control group:ACDF group(n=36).They were observed after operation.Clinical scoring systems included:the Visual Analog Scale for Neck(VAS-N score)and the Arm pain(VAS-A),the Neck Pain and Disability Scale(NPAD)and the European Quality of Life Scale(EQ-5D).Imaging results include surgery adjacent segmental mobility(flexion and extension angle),operative segmental cervical vertebra activity(ROM),and fusion rate.Results:The operation time and bleeding volume of DCI group were significantly lower than those of ACDF group(P<0.05).DCI group and ACDF group were followed up for 12-18 months,an average of 14.6 months.VAS-A score,VAS-A score,NPAD score and EQ-5D score were statistically significant(P<0.05)between the two groups in 3 mouths and 12 mouth,and the clinical outcome was significant.But there was no significant difference between the two groups(the same follow-up time)(P>0.05).There was no significant difference between the two groups(P>0.05).There was no significant difference between the two groups(P>0.05).In the ACDF group,(P<0.05).There was no significant difference between the two groups(P>0.05).There was no significant difference between the two groups(P>0.05),but there was no significant difference between the two groups(P>0.05).There was no significant difference between the two groups(P>0.05).There was no significant difference between the two groups(P>0.05).The difference was statistically significant(P<0.05).There was no significant difference in the DCI group at 3 and 12 months after operation(P>0.05),the difference was not statistically significant(P<0.05).The ACDF group was significantly lower than the preoperative evaluation(P<0.05)(P<0.05).The difference was statistically significant(P<0.05),and the difference was statistically significant(P<0.05)in the DCI group at 3 months after operation,The difference was statistically significant,DCI group 12 months follow-up results,compared with ACDF group mean improvement(P<0.05),the difference was statistically significant.(P<0.001).The ACDF group had a significant difference between the two groups(P<0.001).The postoperative rate of the patients in the DCI group was significantly higher than that in the control group(P<0.001)(P<0.001).There was no significant difference between the two groups(P>0.05).There was no significant difference between the two groups(P>0.05).The difference between the two groups was statistically significant Monthly follow-up results were compared(P<0.001),the difference was statistically significant.The 12-month post-deposition rate was greater in the DCI group than in the ACDF group(P<0.001).The fusion rate at 12 months after operation was greater in the DCI group than in the ACDF group(P<0.001),and the difference was statistically significant.Conclusion:DCI and ACDF treatment of single segment disc degeneration caused by spinal cord or nerve root cervical spondylosis in the short-term follow-up clinical results were satisfactory.DCI can effectively maintain the activity of the surgical segment and reduce the rate of ectopic ossification.The finite element model analysis shows that DCI can better protect the movement of the spine compared with ACDF,and The incidence of postoperative dysphagia is low.