A Comparison Of Long-term Effects Of Two Surgical Methods In Treatment Of Single Level Cervical Disc Herniation

Objective: Compare the long-term clinical efficacy of cervical artificial disc replacement(CADR)and anterior cervical discectomy and fusion(ACDF)in the treatment of single-level cervical disc herniation.Methods: From January 2007 to January2010,87 patients with single-segment cervical disc herniation who underwent surgery in the department of spinal surgery of the first affiliated hospital of Xinjiang medical university were included.They were divided into CADR group(n=38)and ACDF group(n=49)by different surgical methods.At Preoperative and 1,3,6,12 months after surgery and every year after surgery,patients were evaluated by JOA score,VAS score and NDI index as well as imaging,and complications and secondary surgery were recorded.Results: 87 patients were followed up for an average of 134 months.At the last follow-up,JOA,VAS and NDI of the two groups were all improved compared with those before surgery(P<0.05);There was no significant difference in the overall range of motion of C2~C7,range of motion of functional spinal unitand and range of motion of adjacent to upper and lower cervical vertebra in CADR group(P>0.05),range of motion of C2~C7 in ACDF group was significantly decreased before operation(P<0.05),and there was statistical significance between the two groups(P<0.05).At last follow-up,heterotopic ossification occurred in 14 patients in the CADR group,fusion success was 100% in the fusion group.14 patients had adjacent spondylosis,of which 2 underwent secondary surgical treatment.Conclusion: CADR in the treatment of single-segment cervical discherniation achieved the same clinical effect as ACDF surgery during the 10-year follow-up,with little effect on the activity of the operative segment and adjacent segments.