| Objective:A retrospective analysis about ACDF surgery (after anterior cervical discectomy and interbody fusion implant+cage+titanium plate screw fixation) and ACCF surgery (after anterior cervical corpectomy and fusion+titanium mesh implants+titanium plate screw fixation) the clinical efficacy of two techniques in the treatment of cervical myelopathy adjacent double disease (disc height, fusion segments Cobb's angle, JOA score cervical spondylosis, cervical spondylosis Nurick rating) and safety sex (blood loss, operative time,hospital stay, complications) differences, and to explore its significance.Method:Collect 2014 March to October 2015 Affiliated Hospital of Chengdu University of traditional Chinese medicine diagnosis for spinal cord type cervical spondylosis and admitted patients, retrospectively analyzed with 30 patients with diagnosis, inclusion and exclusion criteria, including 15 cases underwent ACDF patients, underwent ACCF patients 15 cases. Were recorded in two groups preoperative, intraoperative and postoperative early metaphase, including efficacy indicators (fusion segment intervertebral disc height, Cobb's angle, cervical spondylosis, JOA score, cervical spondylosis Nurick grade) and safety index (intraoperative bleeding, operation time, hospitalization time, complications) and on the results were analyzed statistically. Results:1?The two groups of patients with lesions of segmental height in preoperative and postoperative 1 month, after 6 month comparison, P values were greater than 0.05 and the first two sets the last increase height difference compared, P =0.333> 0.05, indicating that the two groups of patients in different periods between cervical lesion segment height difference was not statistically significant, the first and the last increase height difference is not statistically significant, but each group of preoperative and postoperative last height difference compared, P< 0.05, the difference was statistically significant, show that after operation, the two groups have achieved good effect, but there were no obvious differences between the two groups.2?The two groups of patients with lesions of segmental Cobb's angle in the preoperative and postoperative 1 month, after 6 month comparison, P values were greater than 0.05 and the first two sets last angle increases compared, P= 0.691> 0.05, indicating that the two groups of patients in different periods between fusion segments Cobb's angle, there was no statistically significant difference. At the end of the first time increases the angle difference is not statistically significant, but each operation before operation and after the last Cobb's angle compared, P< 0.05, the difference was statistically significant, indicating that after operation, the two groups have achieved good effect, but there were no obvious differences between the two groups.3?The two groups of patients with operation time compared p value< 0.05, indicating that there was statistically significant difference between two groups in the operation time, ACCF group, operation time shorter than that in group ACDF; two groups of patients with hemorrhage were compared, P value< 0.05, indicating that patients in the two groups had statistical significance in differences in the amount of bleeding, the ACCF group hand bleeding than ACDF group big; two groups of patients in hospitalization time, P=0.827> 0.05, indicating that the two groups of patients hospitalized time difference was not statistically significant.4?The two groups of operation JO A score, Nurick rating in the before treatment, after treatment for 1 month,3 months,6 months, comparison, P values were greater than 0.05, the difference between the two groups no significant, showed that both compared with the preoperative were significantly improved, but a considerable role.Conclusion:In the adjacent double treatment of cervical spondylosis myelopathy surgical comparison, ACCF intraoperative blood loss than the large ACDF surgery, surgical time than ACDF surgery time is short, but the two procedures in the cervical intervertebral height, curvature differences in hospitalization rates and clinical efficacy aspects of small, can receive a satisfactory clinical efficacy, therefore, restore the radiographic and clinical indicators of efficacy may not be used as the main basis for selecting type of cervical disease by ACCF or ACDF, and sufficient pressure and good exposure of the surgical field, control blood loss and surgical experience should become operative when the surgeon to select the main issues of concern. |
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