A Study On The Clinical Efficacy Of Three Kinds Of Anterior Cervical Surgery In The Treatment Of Cervical Spondylotic Myelopathy

Objective To evaluate the bone graft fusion rate and clinical efficacy of three kinds of anterior cervical surgery in the treatment of cervical spondylotic myelopathy and to provide theoretical reference basis for clinical treatment.Methods From March 2010 to March 2014,90 cases with cervical spondylotic myelopathy were divided into group A,B,C respectively. 31cases in group A underwent anterior decompression and fusion procedures with autogenous iliac crest graft; 29cases in group B underwent anterior decompression and fusion procedures with Titanium mesh crest graft; 30cases in group C underwent anterior decompression and fusion procedures with Cage crest graft. Three kinds of anterior surgery were performed by the same group of physicians. Comparing bone graft fusion rate and clinical efficacy of three kinds of anterior cervical surgery at different times..Results 1 .The average operation time and blood loss of group A is higher than the other groups.There was statistically significant difference between A and the other groups(P>0.05). The hospitalization days of three groups there were no statistically significant difference.2. The incidence of complications at the time of the three months follow-up of A group is higher than the other groups. The incidence of complications at the time of the last follow-up of three groups there were no statistically significant difference.3.Three groups of patients with postoperative 3,6 months follow-up, the bone graft fusion rate of A group is higher than B and C group. When 12 months, the fusion rate of three groups is 96.5%in group A, 94.6% in group B and 95.7% in group C. The result showed no statistical significances between three groups(P>0.05).4.The postoperative JOA scores more obviously improved than preoperative JOA scores of three groups patients. The postoperative JOA improvement rate of three groups is 85.2% in group A,85.3% in group B, 86.9 % in group C. There was no statistically significant difference between groups(P>0.05).5.The rate of good clinical efficacy evaluation (Odom’s standard) The excellent and good rate of B and C group was higher than group A. There was no statistical significance between B and C(P>0.05).Conclusion The short-term effects of bone graft and clinical curative effect of three kinds of anterior cervical surgery is fine. The operation time of group A is longer than the other two groups,and the donor area pain occurs frequently. The short-term bone graft fusion rate of group A is higher than the other two groups. As for the operative procedure of group B and C are relatively simple. The fixation and bone graft fusion rate of 12 months of group B and C with no significant differences with group A. So the operative procedure of group B and C are better for the treatment of myelopathic type cervical vertebra disease.