Comparative Study On Long-term Results Of Anterior Route Three Surgical Methods For Cervical Spondylotic Myelopathy

Abstract:Objective To evaluate the long-term results of three kinds cervical anterior route vertebra fusion in the treatment of cervical spondylotic myelopathy(CSM). Methods Eighty-five cases of anterior cervical decompression and fusion were performed with different methods of bone graft and anterior plate from January 2005 to January 2009,25 cases were used with allograft bone(A group); 31 cases were used with autologous bone(B group); 29 cases were used with titanium mesh(C group).All the patients were followed up from 3 to 7 years,with an average of 5.6 years. JO A and VAS scores were used for clinical assessment. The regular X-ray were used to measure the change of intervertebral height and cervical spine curvature to identify the vertebral fusion. Results (1)A1185 patients after the operation the JO A score increased obviously, the neck and shoulder pain were significantly improved (P< 0.05).There was no significant difference among the three groups(P>0.05), and no significant difference within groups(P> 0.05); (2) Three groups of patients with intervertebral height were increased compared with.the preoperative(P<0.01), group A, B after 3 months,6 months,12 months, and the final visit compared with 3 days after were no significant difference(P> 0.05),no significant difference among the three groups(P>0.05), group C after 12 months and the final visit compared with 3 days,3 months,6 months later were statistically significant(P<0.05), there was no significant difference between the 12 months results and the final visit(P>0.05); (3)The postoperative intervertebral height and the cervical overall curvature were restored than before (P<0.05),and maintained in a good condition for a long time. (4) There were statistically significant between group A, B and C in 3months and6 months (P< 0.01), the integration time in group A was longer than group B and C; the fusion rate in the final visit of the three groups were 96.0%,96.7%,96.5%, and there was no significant difference among the three groups(P>0.O5).(5)There was no meshes found displacing or subsiding,no plate loose and breakage.Conclusion The three kinds of anterior decompression and interbody fusion by surgery can significantly reduce the symptoms of cervical spondylotic myelopatby, the long-term efficacy is satisfied.Operators should choose the operation methods according to the specific situation of the patients to achieve the most satisfactory clinical efficacy.