Long Curative Effect Comparison Of Anterior Discectomy And Fusion And Bryan Artificial Disc Replacement In The Treatment Of Cervical Spondylotic Myelopathy

Background:Anterior cervical discectomy and fusion (ACDF) has developed to be the gold standard for surgical treatment of cervical myelopathy for decades, but ACDF can lead to the acceleration of adjacent segment disease (ASD). Bryan artificial disc replacement (ADR) has been used worldwide as an alternative of ACDF since2002. Many studies focus on the effect and safety of Bryan artificial disc replacement, however studies focus on cervical spondylotic myelopathy (CSM) and studies of long-term follow up were rare.Purposes Collecting the clinical and radiographic data and compared the data using the statistical method to tell the differences and to evaluate the safety and effect of Bryan artificial disc replacement.Patients and methods:Selecting64patients according to the inclusion and exclusion criteria and follow them up since operations. Collecting the clinical outcomes (such as Modified Odom’s criteria, JOA, SF-36and NDI) and radiographic outcomes (such as range of motion, incidence of heterotopic ossification, etc.). Incidences of complications were recorded and compared as well. Comparing the data using statistical methods performed by SPSS19.0. ResultsPatients in both groups got better after operation and there are no significant differences(p>0.05).JOA:ADR from7.9±1.4to14.0±1.5; ACDF from8.0±1.2to14.2±1.3; NDI:ADR from48.0±5.5to20.4±5.4; ACDF from48.7±5.7to21.6±3.4; PCS:ADR from32.8±3.7to48.4±7.5; ACDF from32.9±3.2to47.6±5.6; MCS:ADR from30.3±3.7to48.7±7.3; ACDF from31.9±2.7to49.6±4.6. ADR preserved the motor function of index level and got a high incident rate of HO.ConclusionAccording to the inclusion and exclusion criteria firmly, there is no significant differences between ACDF and ADR in the treatment of cervical spondylotic myelopathy.