Clinical Characteristics And Effect Of Anterior Surgery Of Cervical Spondylosis In Youth

[Objective]To explore the clinical characteristics and effects of anterior approach operation of cervical spondylosis in young patients[Methods]Forty-eight patients of cervical spondylosis who were no more than 35 years old and surgically treated by anterior cervical discectomy and fusion(ACDF)or anterior cervical corpectomy decompression(ACCF)in our hospital from January 2006 to July 2015 were retrospectively studied.The research includes 28 males and 20 females,whose average age is 32.23±4.13 years old.Combined with medical history and imaging data,we make the characteristics analysis of youth and evaluate the anterior surgical effects by comparing the preoperative and postoperative Cobb's angle and depth of cervical arch changes,as well as cervical Japanese Orthopedic association(JOA)scores,VAS scores.[Results]Thirty-seven patients were beyond 30y and there were 25 office workers(>5h per day)and 12 heavy manual workers.7 patients have a history of cervical injury before.The average course of disease was 5.53±7.39m and follow-up was 3.44±2.96y.The research includes myelopathy 27 cases,radiculopathy 18 cases and mixed type 3 cases,including 87 lesion segments,with 34 C5/6 levels,which was the most.There were 13 and 35 cases respectively in ACDF group and ACCF group.The VAS scores of radiculopathy decreased from 10.35±1.96 preoperative to 15.41 ± 1.41 postoperative,and the improvement rate was 77.8±17.3%.The JOA scores of myelopathy increased from 7.61 ± 1.12 preoperative to 0.64±0.61 postoperative.Cobb's angle improved from-15.3?23.1°to-2.6?26.1°(average change 9.25±4.52°),and the depth of cervical arch improved from-10.1?9.1mm to-3.5?10.7mm(average change 6.64±3.40mm).Two anterior approaches had no statistically significance on the recovery of neurological function,the restoration of curvature and the depth of cervical arch.ACCF group had a more virous loss of blood and there were significantly relationship between Cobb's angle and the depth of cervical arch.All the patients with more than 6-month follow-up returned to their work.[Conclusion]Juvenile cervical spondylosis occurs frequently in people who were used to prolonged bow desk or heavy manual labor,especially beyond 30y.The main pathological change is the loss of cervical alignment.Anterior approach operation helps relieve the pain,elevate the neurological function and improve the cervical alignment There are no statistically significance between the results of two anterior approaches except blood loss.