Cervical Spine Fusion And The Fusion Of Adjacent Segment Degeneration After Clinical Studies

Cervical lesions in orthopedics for the frequently-occurring disease, such as conservative treatment fails, surgical treatment can be taken. More than half a century, cervical fusion surgery has been effective and reliable means for the treatment of cervical lesions, affirmed by the majority of orthopedic surgeons because of the good clinical results, especially between the anterior cervical discectomy decompression and fusion (of ACDF) is considered the "gold standard" for treatment of degenerative cervical spondylosis. But rich in the development of medical technology, clinical data, postoperative complications of integration has been more attention, especially in the fusion of adjacent vertebral bodies after degeneration.Agreed that the fusion after spine biomechanical changes, integration of activities segment to reduce the original cervical units of activity and stress redistribution of the adjacent vertebral body stress is more concentrated, thus accelerating the degeneration of the adjacent vertebral bodies. Limitations based on the fusion surgery, spinal fusion technology because of its advanced concepts to be respected, while the non-integration in the cervical spine, with emphasis reflects the cervical artificial disc replacement surgery.This article reviews some of the major cervical open surgery in the majority of orthopedic surgeons fusion and non-fusion surgical procedures, details of fusion and non fusion after the adjacent vertebral degeneration. Traditional medicine is a wonderful work of our culture, and recorded the details of the treatment of cervical degenerative changes also be reflected in the synthesis. The clinical research component of the main line of typical cases of cervical spine surgery in recent years were treated by the orthopedic center of Beijing University of Traditional Chinese Medicine, Dongzhimen Hospital, follow-up study, combined with the data obtained from the clinical point of view of cervical fusion and non-fusion surgery to retire the adjacent vertebral bodies change the degree of influence.Objective:Cervical fusion surgery and non-fusion of adjacent vertebral degenerative changes in the clinical observation after, and to investigate the cervical non-fusion (mainly referring to the advantages of the cervical artificial disc replacement surgery) in the prevention and treatment of the adjacent vertebral lesions.Methods:Select83cases since September2007June-2008Orthopaedic Center of Beijing University of Traditional Chinese Medicine, Dongzhimen Hospital, the treatment of degenerative cervical lesions surgically divided into anterior cervical decompression and fusion group and cervical artificial discreplacement group. Retrospective study, each period the two groups of patients preoperativeand postoperative JOA score, pain visual VAS score, and imaging studies (degeneration grade, the upper and lower intervertebral activity) measurement records. Application the SPSS18.0Software, relevant information for statistical analysis.Results:Postoperative JOA score of the cervical spine, pain visual VAS score before surgery compared to the significantly improved, there is significant difference (P<0.05) difference between the two groups in postoperative early and late compared to a significant difference (P<0.05); in the degeneration of the adjacent vertebral bodies, fusion group, the preoperative and postoperative24months,36months after obvious difference was statistically significant (P<0.05), while the disk group between preoperative andat various time intervals after surgery was not statistically significant (P>0.05). The two groups in December after24months after surgery, postoperative36months compared statistically significant (P<0.05); fusion group, surgical segments above the intervertebral activity in the36months after surgery compared with preoperative activities The degree has been reduced significantly (P<0.05) above the disk group interbody activity preoperative and postoperative time periods compared to no significant change was not statistically significant (P>0.05). Surgery below the segmental intervertebral activity, the fusion group after June, December,24with preoperative activity has increased, there is a significant difference (P<0.05), while the disc group activities The degree of change in small, not statistically significant compared with preoperative (P>0.05).Conclusion:Anterior cervical discectomy decompression and fusion group and two cervical artificial disc replacement group treatment of cervical disease have good clinical efficacy in the early postoperative period, but with the postoperative follow-up time extend the cervical artificial disc replacement groupadjacent segment degeneration to be significantly lower than in the anterior cervical decompression and fusion group, the cervical artificial disc replacement adjacent segments may occur degeneration.