| BackgroundCervical spondylotic myelopathy(CMS)in the various types of cervical disease is in the incidence of 12%to 30%,usually slow onset to 40 to 60 years of age in middle age.With the increase of age,the incidence rate gradually increased.At present,there are two most common surgical methods:anterior cervical discectomy and bone graft fusion(ACDF)and anterior cervical spondylomy fusion(ACCF).ACCF commonly used bone graft material mainly includes autologous iliac,titanium mesh,nano-hydroxyapatite/polyamide 66(n-HA/PA66)cervical support.In the previous study,different researchers on the above-mentioned bone graft material or only one of the application of research,or two of the comparative analysis of the results,while the three comparative analysis at home and abroad there is no relevant research Reported that,in clinical work,with the number of ACCF cases and follow-up observation time increased,found that some of the conclusions of previous studies are biased,through this study can be more comprehensive and accurate evaluation of the application of the three Contrast,for the ACCF in the selection of bone graft material to provide clinical guidance.Objective1.To compare the clinical effect and difference of autologous iliac bone and titanium mesh in the treatment of cervical spondylotic myelopathy with ACCF.2.To compare the clinical effect and difference of titanium mesh and n-HA/PA66 cervical vertebrae in the treatment of cervical spondylotic myelopathy with ACCF.3.To compare the clinical effect and difference of application of autologous iliac bone,titanium mesh and n-HA/PA66 cervical vertebrae support in the treatment of cervical spondylotic myelopathy with ACCF.Methods1.A total of 112 patients with cervical spondylotic myelopathy were treated retrospectively from January 2010 to January 2015 in Guangzhou General Hospital of Guangzhou Military Region.All of them were treated with anterior cervical decompression and bone graft fusion Treatment,37 cases of autologous iliac bone graft,40 cases of titanium mesh bone graft,35 cases of n-HA/PA66 cervical support bone graft.2.The Cobb angle of the fusion segment and the C2?7Cobb angle,D value,and the anterior vertebral body were measured before and after operation,3 months,6 months and 9 months after operation.Vertebral anterior height(HAB),posterior margin height(HPB).3.SPSS 19.0 statistical software was used for statistical analysis.Two independent samples were used for t test.The difference between the two groups was matched by t test.The three groups were compared by one-way ANOVA.The LSD-t test was used to compare two groups;The count data were compared with the x2 test,and the difference was statistically significant(P<0.05).Results1.Three groups of patients with general information using one-way analysis of variance,there was no significant difference in gender,age and subtotal resection of vertebral body(P>0.05),which was comparable.There were significant differences in operative time,intraoperative blood loss and hospitalization time(P<0.05).2.The JOA scores of the three groups were significantly higher than those before operation(P<0.05),and the neurological function recovered well.There was no significant difference in JOA score and improvement rate between the three groups(P>0.05).3.In three groups of patients,the difference between Immediately after surgery and preoperative D value and the difference of Cobb angle between Immediately after surgery and preoperative fused segments was statistically significant(P<0.05).There were no significant differences in Cobb angle,C2?7 Cobb angle and D value of the three groups at Other different periods(P>0.05).4.Three groups of patients immediately after surgery and preoperative,postoperative 3 months and immediately after the integration of high and posterior segment(P<0.05).Compared with n-HA/PA66 cervical vertebral body,there were significant differences between the two groups(P<0.05).There was a significant difference between the two groups(P<0.05).The height of the autologous iliac bone group was significantly higher than that of the titanium mesh group and the n-HA/PA66 cervical vertebrae group(P<0.05),but there was no significant difference between the three groups before and after fusion(P>0.05).5.There were significant differences between the three groups(P<0.05),the autologous iliac group and the titanium mesh group,n-HA/PA66 cervical vertebrae There was significant difference between the two groups(P<0.05).There was no significant difference in the fusion rate between the three groups(P>0.05).There were no significant differences in the sedimentation rate between the iliac group and the titanium mesh group and the n-HA/PA66 cervical vertebral body group at 6 and 9 months after operation.Statistically significant(P<0.05).There was significant difference between the titanium mesh group and the nHA/PA66 cervical vertebral body group at 6 and 9 months after operation(P<0.05).ConclusionNano-hydroxyapatite/polyamide 66(n-HA/PA66)cervical vertebrae support relative to titanium mesh support bone graft,autogenous iliac bone with early fusion rate,low sedimentation rate,fewer complications;titanium mesh N-HA/PA66 cervical vertebral support is superior to titanium mesh in maintaining the curvature of cervical spine and the height of intervertebral nerve,and it has the advantages of high early fusion rate,low sedimentation rate and no bone defect.Autologous iliac bone,titanium mesh is superior to autologous iliac bone,so n-HA/PA66 cervical vertebrae support is a more ideal support bone graft material,long-term efficacy to be further follow-up. |
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