The Influence Of Intervertebral Height Recovery To Patients With Single Cervical Degenerative Disc Disease Treated With ACDF

Objective:To investigate the effect of the ACDF(anterior cervical discectomy and internal fixation and bone graft)in treating to single Cervical degenerative disc disease,we discussed the intervertebral height recovery in association of clinical curative effect,so providing appropriate height recovery to surgeons for reference.Methods:We retrospectively analyzed 150 cases of CDDD underwent single segment ACDF patients,admitted from January 2012 to December 2014 in the First Affiliated Hospital of Dalian Medical University,male and female were 95,55 respectively,the range of age is 51 years old to 83 years old,the meane age is(65.39± 9.59)years old.Site of involvement:C3/4 in 9 patients with C4/5 and C5/6 in 30 cases with C6/7 in 15 cases.According to the operation of the intervertebral height recovery degree compared with the percentage of reference height,we randomly divided them into group A(postoperative intervertebral disc height/target reference height in 100-120%B group(28 cases);the immediate postoperative intervertebral disc height/target reference height in 120-140%C group(63 cases);the immediate postoperative intervertebral height/the target intervertebral height located in the benchmark 140-160%)in 59 cases.By comparison,there was no significant difference among the patients between groups in demographic and surgical site distribution.We compared neurological recovery rate,the incidence of neck axial symptoms,intervertebral height changes,degeneration of adjacent segment index pre,post operatively and at last follow-up.Anayzing different intervertebral height recovery degree on the influence on clinical outcomesResults:1.The age and sex of the patients in the three groups were analyzed by independent sample test between the 22 groups,P>0.05.There was no significant difference between the three groups in the age distribution,indicating that the three groups were comparable.2.The results of preoperative JOA analysis of the three groups showed no statistical difference between the three groups,F=924,p=0.399,greater than 0.05.The JOA scores of the three groups were significantly improved,and the difference was statistically significant.The recovery rate of nerve function:B group 71.88%was better than group C,which was better than group A,and the recovery rate of 120-140%was higher than that of group(42.25%).3.Of the patients with cervical spondylosis of the cervical spine,the proportion of cervical AS was 35.71%,15.87%and 42.37%,respectively,at the age of 2 years after anterior cervical fusion in the three groups.Three groups of patients with postoperative AS incidence of in the A group and C group,the incidence of axial symptoms were higher than the B group,there were statistically significant differences.B group 120-140%intervertebral space height is the best choice.4.When compared right just after operation,the height of intervertebral space was higher than that of group BC,but there was no significant difference between BC group and A group.At the last follow-up,the height of intervertebral space was lost,and the height of C group was the highest,which was significantly different from that of AB group.5 in the average follow-up time of 2 years,considering the amount loss of adjacent intervertebral space,minimum loss were observed in B group specifically when compared with A group,C group,P value<0.05,there were statistical differences.There was no significant difference between A group and C group.Conclusion:Based on our clinical retrospective study,during 2 years of follow-up,we found that when the recovery of intervertebral height were 100-160%,there were no serious complications such as spinal cord retractions,all patients were achieved good effect.Among them,in the height of 120-160%,JOA is higher.and the function of neural network is better.Conclusively,considering the postoperative cervical axial symptoms,follow-up objective loss of intervertebral height,adjacent intervertebral height loss,we highly recommended that the ACDF intervertebral height recovery of 120-140%should be considered as a benchmark when performing ACDF.