Efficacy Analysis On Anterior Hybrid Decompression In Treatment Of Multilevel Cervical Spondylosis

Background Anterior cervical decompression and fixation is commonly used in theSingle segment or double segment cervical spondylosis, but the choice of surgicalapproach has been controversial for multilevel cervical spondylosis. posterior surgeryhas been praised by domestic and foreign scholars for multilevel cervical spondylosis,but some scholars believe that simple posterior surgery oppression can not lifte the frontof the oppression. Therefore, anterior cervical decompression and fixation has also beenmore and more attention in multilevel cervical spondylosis. The traditional anteriorcervical surgery is two corpectomy were removal with fusion and fixation, it had thehigher incidence of loosening displacement of the grafts, plates and screws, due to thenormal cervical structure was too much damaged, the length of the fusion segment wasextended and the stress of implants were increased. The anterior hybrid decompressioncan retain normal structure of the cervical spine through decompression, increase thefusion rate and efficiently improve the cervical physiological curvature andintervertebral height, thus it can be used in treatment of multilevel cervical spondylosis.The anterior hybrid decompression can retain normal structure of the cervical spinethrough decompression, increase the fusion rate and efficiently improve the cervicalphysiological curvature and intervertebral height, thus it can be used in treatment ofmultilevel cervical spondylosisObjective To discuss the clinical effect of anterior hybrid decompression technique(subtotal single vertebrectomy combined withintervertebral discectomy) in thetreatment of multilevel cervical spondylosis. Methods Retrospective analysis was performed in30patients with multilevel cervicalspondylosis. All the patients received anterior hybrid decompression, autogenous iliacbone graft ing or ZEPHIR plate internal fixation.12cases of male patients,18cases offemale patients, age42-65years of age, mean age56years, duration of three months8years, with an average duration of20months.25cases of patients with neck andshoulder pain,18cases of patients with chest strap,27cases of limb numbness,weakness, unsteady gait, tendon hyperreflexia, hands Hoffmann sign was positive. Thepatients were diagnosed as multilevel cervical myelopathy underwent X-ray plain film,MRI, CT or3D-CT reconstruction. Lesions involving the segments (C3-C611cases,C4-C719cases). C4corpectomy and C5/6discectomy six cases, C5corpectomy andC3/4discectomy seven cases, C5corpectomy and C6/7discectomy nine cases, C6corpectomy and C4/5discectomy eight cases. The neurological function scores, fusionrates, cervical physiological curvature and intervertebral height, and complications ofpatients were analyzed after treatment.Results The patients were followed-up for12-72months, with an average of36months. The cervical physiological curvature and the intervertebral height weresignificantly improved after surgery. The spinal cord of oppressed segments was wellbulged. Loosening, fracture and displacement of the plates and screws were not foundduring the follow-up. The postoperative fusion rate was100%at6months. TheJapanese Orthopaedic Association scores were obviously improved after12months offollow-up. The improvement rate outcome showed excellent in10cases, good in16cases, fair in4cases, and the good rate was86.7%.Conclusion The anterior hybrid decompression can completely remove the oppressionof the nerve tissue, retain normal structure of the cervical spine,shorten the length of the fusion segments, reduce the stress of the screws upper and lower of the steel plate,improve the stability and fixation strength, increase the contact surface of the graft,preserve the blood supply of the central vertebral body, increase the fusion rate andavoid the formation of pseudoarthrosis.. ZEPHIR plate can obtain immediate stabilityand the role of tension load, significantly improve the fusion rate, efficiently increasethe cervical physiological curvature and intervertebral height, improve the improvementof neurological function, reduce the degeneration of postoperative neighboring segmentand obtain the satisfactory short-term and long-term efficacy. Therefore, the anteriorhybrid decompression is a safe and effective surgical approach to treatment multilevelcervical spondylosis.