| Background and PurposeCervical myelopathy cervical spondylosis the most serious type, epidemiological statistics 50 people over the age of high hair, and with changing lifestyles, the incidence of the disease increasingly younger crowd, but once the delay treatment, often develop into irreversible neurological damage, seriously affecting people's daily lives. Traditional surgical treatment of cervical myelopathy "gold standard" for the anterior cervical decompression and interbody fusion with internal fixation(ACDF), but a large number of patients reported in the literature ACDF occur degeneration(ASD) adjacent segment some even require surgery. In recent years, spinal non-fusion technology advances, we use dynamic cervical stabilization(DCI) implantation for treatment of single segment cervical myelopathy, and mid-term follow-up and retrospective comparative study in patients with concomitant ACDF observed this kind of surgery whether the formula can effectively prevent postoperative ASD, to enrich the treatment of the disease. MethodMarch 2011 to January 2013. 23 patients in our department DCI implantation, 15 cases were male, 8 female, aged 38-55 years, mean 47.5 years, of which the affected segment a total of six cases of C4-5, a total of 12 cases of C5-6, C6-7 a total of five cases, included in the DCI group. Screening in our department over the same period anterior cervical decompression and interbody fusion 47 patients with internal fixation, in which a total of 3l male, female 16, aged 35-64 years, mean 50.3 years, of which the affected segments of a total of three cases of C4-5, a total of 21 cases of C5-6 21 of, C6-7 a total of 13 cases included ACDF group. Compared two groups of patients gender, age of onset, segments and type of disease lesions, etc., the difference was not statistically significant(P>0.05). All patients underwent conservative treatment systems, poor efficacy. Exclusion criteria: severe cervical spine instability, posterior longitudinal ligament, severe osteoporosis, severe stenosis or autonomous target gap fusion, bone cervical stenosis, vertebral fractures or vertebral body tumors, associated with other serious diseases, and systems metal allergy. All patients underwent preoperative cervical spine, lateral position and power X-ray, cervical MRI and CT scan results showed that all patients had varying degrees of degenerative cervical disc, highlighting, as well as spinal cord or nerve roots that pressure change. 24,36,48 end of month All patients underwent a complete outpatient specialist examination, recording the Japanese Orthopaedic Association(JOA) score and shoot height and activity of X-ray observation target and a gap up and down the adjacent segment data activity, the resulting mean ± standard deviation( sx ?)that the application of SPSS 17.0 statistical software analysis, data were compared before and after surgery were statistically significant by t test for quantitative data analysis, longitudinal group within this diversity were used to compare the number of single-factor analysis of variance. ResultsAll patients were followed up for 24-48 months, an average of 44 months, two groups of patients in the intraoperative and postoperative complications were not serious. ACDF group for all surgical patients X-ray showed all segments of bone fusion, internal fixation without loosening, shedding, subsidence, etc. No looseness in the DCI group fixation and translocation either.Each of postoperative JOA score and intervertebral height were higher than before surgery, and the differences were statistically significant(P<0.05); the difference was not statistically significant(P>0.05). DCI Group target segments ROM and follow-up period before each surgery, the difference was not statistically significant(P>0.05). DCI group vertically adjacent segments ROM compare the end of follow-up with the preoperative, the difference was not statistically significant(P>0.05); ACDF group vertically adjacent segments ROM before the end of each follow-up compared with patients increased, and the difference was statistically significant(P<0.05). Each end of follow-up between vertically adjacent ROM group, ACDF group is greater than the DCI group, and the difference was statistically significant(P<0.05). ConclusionThe two procedures could significantly relieve symptoms, restore and maintain disc space height. Compared with the ASDF, DCI provides continuous dynamic stability for the operation segment and may play a positive role for delaying the occurrence of ASD. |
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