Effect Of Anterior Cervical Decompression Fusion And Partial Resection Of Uncinate Vertebra Joint On Cervical Sagittal Sequence In Patients With Non-single-segment Radiculopathy And Its Correlation With Curative Effect:A Retrospective Analysis

[Objective]:By analysing the effect of preservation or resection of the partial uncinate joint on the sagittal sequence of the cervical vertebrae in patients with non-single-segment radiculopathy and the correlation between the sagittal sequence of the cervical vertebrae and the long-term effect after surgery,we explored whether it is necessary to perform partial resection of the uncinate joint in patients with cervical spondylotic radiculopathy undergoing anterior cervical decompression and fusion(ACDF).[Methods]: The study retrospectively analysed 96 patients with cervical spondylotic radiculopathy with more than two segments from August,2016 to January,2021,who underwent ACDF(ACDF group,45 patients)or ACDF combined with partial uncinate joint resection(ACDF+UT group,51 patients).Here,partial resection of the uncinate joint indicated removal of part of the uncinate joint and osteophyte based on the compression of the nerve root during surgery,whereas the uncinate joints in the ACDF group were retained completely.The imaging data and functional scores of the two groups were recorded before surgery,1 month after surgery,and at the last follow-up.In the statistical analysis of the two groups,a paired t-test was applied to the data with normal distribution,while a rank sum test was applied to the data with non-normal distribution.In addition,the correlation between the imaging parameters and functional scores was validated using the Pearson’s test.[Results]: All 96 patients successfully completed the surgery and were followed up for at least 12 months,with an average follow-up time of 14 months.At the last follow-up,the pain visual analogue scale(VAS),neck disability index(NDI),and neck pain and disability scale(NPAD)scores of the two groups were significantly lower than those before surgery,and the Japanese Orthopaedic Association(JOA)score was significantly higher than that before surgery.At the last follow-up,compared with the ACDF+UT group,the NDI and NPAD scores in the ACDF group decreased more significantly(p<0.05),and C2-C7 SVA,△C2-C7 SVA(the difference between C2-C7 SVA at last follow-up and before operation),and T1 S values decreased significantly(p<0.05).The Pearson correlation test showed that at the last follow-up,the C2-C7 Cobb angle was positively correlated with the JOA score and T1S(p<0.05)and negatively correlated with the VAS,NDI,and NPAD scores and CGH-C7SVA(p<0.05).C2-C7 SVA was positively correlated with CGH-C7 SVA and T1S(p<0.05).The △C2-C7 Cobb angle was positively correlated with △JOA score(p<0.05)and negatively correlated with △VAS,△NDI,and △NPAD scores(p<0.05),while △C2-C7 SVA and△CGH-C7 were negatively correlated with △JOA score(p<0.05)and positively correlated with △NDI and △ NPAD scores(p<0.05).[Conclusion]: Patients with non-single-segmental cervical spondylotic radiculopathy and ACDF with or without uncinate joint resection can have effective improvement in the clinical effect and sagittal balance;however,partial uncinate joint resection has a certain negative impact on the long-term reconstruction of sagittal balance and long-term effects in patients after surgery.