| Objective To retrospectively analyze the clinical efficacy of four fusion methods of autograft,cage plus autograft,cage plus hybrid bone(autograft in conjunction with allograft)and cage plus allograft in the application of single-segment anterior cervical decompression and fusion(ACDF).Methods 107 patients who underwent the single-segment anterior cervical decompression and fusion between January 2011 and January 2018 were reviewed.They were divided into four groups according to different intervertebral fusion methods.Group A was treated with iliac bone graft fusion in 25 cases,male in 13 cases and female in 12 cases.Group B was treated with Cage plus autogenous bone graft fusion in 30 cases,male in 6 cases and female in 14 cases.Group C was treated with Cage plus autograft and allograft fusion in27 cases,male in 14 cases and female in 13 cases.Group D was treated with Cage plus allograft fusion in 25 cases,male in 12 cases and female in 13 cases.The spinal cord nerve function was evaluated by J0 A score,and the occipital and cervical pain symptoms were evaluated by VAS score.The operation time,intraoperative blood loss,preoperative and postoperative J0 A and VAS scores,fusion and the height of the intervertebral barrier of the operation segment of the four groups of patients were recorded and compared.Results All 107 patients were followed up for an average of 11.8 months(3-15months).There was no difference in gender,age and operative segment between the four groups(P>0.05).the four groups were comparable.There was no statistical difference in the operation time and intraoperative blood loss among the four groups(P>0.05).The postoperative JOA and VAS scores of each group of patients were better than before(p <0.001).There was no significant difference between J0 A score and VAS score subgroups at the same time point after operation(P>0.05).The fusion rate of group A patients was84.00%,96.00% and 100% respectively at 3 months,6 months and 1 year after operation.The fusion rates of group B patients were 46.67%,93.33% and 100% respectively at 3 months,6 months and 1 year after operation.In group C,the fusion rates were 48.15%,96.30% and100% respectively at 3 months,6 months and 1 year after operation.The fusion rate of group D patients was 48.00%,96.00% and 100% respectively at 3 months,6 months and 1 year after operation.At 3 months after operation,the fusion rate of group a was higher than that of groups B,C and D(p < 0.008).There was no statistical difference between groups B,C and D(P>0.05),and there was no statistical difference between groups at 6 months and 1 year after operation(P>0.05).There was no statistical difference in intervertebral height between groups at the same time point after operation(P>0.05).The intervertebral height of the four groups immediately after surgery were better than before(p < 0.001).There was no significant difference between the 3 days postoperatively and the preoperative intervertebral height difference(P>0.05).There was a statistically significant difference between the 1 year and 3 days postoperative height difference(P<0.05).The difference of group A was higher than that of the other three groups.there was no statistical difference between groups B,C and D(P>0.05).No spinal cord injury or dural rupture occurred during the operation in the four groups of patients.One case of recurrent laryngeal nerve injury occurred in group A after operation.Conclusion 1.The four fusion methods of autograft,cage plus autograft,cage plus hybrid bone(autograft in conjunction with allograft)and cage plus allograft in the application of single-segment anterior cervical decompression and fusion all achieved good clinical effects.2.At the last follow-up,the four groups of cases obtained similar fusion effects,and the cases of group A fused faster than the other three groups: 3.The four intervertebral fusion methods have similar intervertebral height recovery effects,and group A is not as good as theother three groups in reducing intervertebral space loss.. |
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