A Comparative Analysis Of The Clinical Efficacy Of Microscope-assisted Anterior Cervical Surgery Versus Conventional Anterior Cervical Surgery In The Treatment Of Cervical Spondylosis

Objective:To compare the clinical effect of microscope-assisted anterior cervical decompression and fusion with that of conventional anterior cervical decompression and fusion in the treatment of cervical spondylosis.Methods:The clinical data of patients with cervical spondylosis treated by anterior cervical surgery in affiliated hospital of yan 'an university from January 2014 to December 2019 were retrospectively analyzed.Among them,68 were male and 13 were female.There were 44 cases of nerve root type and 37 cases of myeloid type.There were46 cases with single segment and 35 cases with double segment.Aged 28-80 years(51.59±12.08);According to the surgical methods,the patients were divided into the conventional group and the microscope group.The conventional group was treated with conventional Anterior Cervical Discectomy and Fusion(ACDF).The microscope group was treated with microscope-assisted ACDF surgery.The preoperative general data and relevant scores of the two groups were calculated and compared,mainly including: age,gender,classification and segment;JOA Scores(Japanese Orthopaedic Association Scores),Visual Analogue Scale of Neck(VAS),upper limb VAS,Neck Disability Index(NDI),c2-c7 cobb Angle and fused intervertebral height showed no statistically significant differences between the two groups(P > 0.05),suggesting comparability.Compared to patients with preoperative and postoperative 3 days,postoperative march related indicators,mainly includes: JOA score,VAS in neck,upper limb VAS,NDI,intervertebral height and Angle of C2-C7 Cobb fusion operation time,blood loss,incision length,length of hospital stay,postoperative flow and drainage time,and whether the complications,all data statistical comparison evaluation.Results:There were statistically significant differences in JOA score,neck VAS,upper limb VAS,NDI,c2-c7 cobb Angle and fusion intervertebral height in the conventional group before and 3 days after surgery(P < 0.05).There were statisticallysignificant differences in JOA score,neck VAS,upper limb VAS,and NDI between 3days and 3 months after surgery(P <0.05),but no statistically significant differences in c2-c7 cobb Angle and fusion intervertebral height(P >0.05).There were statistically significant differences in JOA score,neck VAS,upper limb VAS,NDI,c2-c7 cobb Angle and fusion intervertebral height in the microscope group before and 3 days after surgery(P < 0.05).There were statistically significant differences in JOA score,neck VAS,and upper limb VAS between 3 days after surgery and 3 months after surgery(P <0.05),but no statistically significant differences in NDI,c2-c7 cobb Angle and fusion intervertebral height(P >0.05).The differences in JOA score,neck VAS,and upper limb VAS were statistically significant(P < 0.05),but there were no statistically significant differences in NDI,c2-c7 cobb Angle and fusion intervertebral height(P >0.05).There was no statistically significant difference in JOA score,neck VAS,upper limb VAS,NDI,Cobb Angle of fusion segment,and intervertebral height of fusion between the two groups 3months after surgery(P > 0.05).There was no statistically significant difference between the conventional group and the microscope group in the complications of nerve root or spinal cord injury,esophageal injury,cerebrospinal fluid leakage,dysphagia,recurrent laryngeal nerve stimulation symptoms,wound infection,loosening of internal fixation,and fracture(P >0.05).The differences in operation time,blood loss,incision length,length of stay and drainage volume between the microscope group and the conventional group were statistically significant(P < 0.05),while the differences in drainage time were not statistically significant(P >0.05).Conclusion:Both of the two surgical methods have significant curative effect on the treatment of cervical spondylosis,while the immediate postoperative curative effect of the microscope group is better than that of the traditional group,and there is no significant difference in the long-term clinical curative effect.In addition,the microscope group had significant advantages of fine operation,less intraoperative bleeding and shorter postoperative recovery time.