Therapeutic Effect And Efficiency Evaluation On Key-Hole And ACDF For Cervical Spondylotic Radiculopathy By Data Envelopment Analysis

Objectives:In order to solve the following problems,using DEA model to analyze the efficiency of Key-hole and ACDF and comparing the intraoperative and postoperative observation indexes of them.1.Compare the early clinical efficacy of Key-hole and ACDF in the treatment of single segment cervical spondylotic radiculopathy;2.Analyze the potential advantages of Key-hole operation;3.Compare the efficacy of Key-hole and ACDF in the treatment of single segment cervical spondylotic radiculopathy;4.Explore the applicability of DEA in the evaluation of orthopedic surgery.Methods:1.From June 2016 to June 2019,a retrospective study was conducted on 30patients with single segment cervical spondylosis radiculopathy who were operated in the Department of Orthopedics,Affiliated Hospital of Chengdu University of traditional Chinese medicine were divided into the observation group(Key-hole group)of 14 cases and the control group(ACDF group)of 16 cases;2.The operation time,hospitalization time,cost of orthopedic treatment,SF-MPQ pain score,NDI score and JOA score of the two groups were counted;3.Clinical efficacy comparison,SPSS 25.0 was used for data analysis,Fisher test was used for counting data,Mann-Whitney test was used for rank data,and x±s was used for measuring data.Independent sample t-test was used for comparison between groups,and paired sample t-test was used for comparison at each time in the group,P<0.05 was statistically significant;4.Compare the operation efficiency.Each patient is regarded as an independent decision making unit,operation time,hospitalization days and operation cost are regarded as input indicators,and SF-MPQ pain score,NDI score and JOA score are regarded as output indicators.Use deap2.1 software to calculate the efficiency value of each independent decision making unit in C~2R model and BC~2 model,summarize the operation efficiency value,and get the slacks in BC~2 model.Results:1.There was no statistical difference between the two groups of patients in gender,age,operation segment,pain and functional score and other preoperative information(P>0.05);2.The results showed that there was no significant difference in SF-MPQ pain score,NDI score and JOA score at the same time point between the two groups(P>0.05).The results showed that there were significant differences in SF-MPQ pain score,NDI score and JOA score between the two groups at different time points after operation and before operation(P<0.05);3.The differences of operation time,hospitalization days and treatment cost between the two groups were statistically significant(P<0.05);4.There were 3 cases of operation related complications in the two groups.The Key-hole group included one patient with transient nerve injury and one patient with residual nucleus pulposus.In ACDF group,one patient had dyspnea after operation.All the three patients were discharged after symptomatic treatment;5.Under C~2R model and BC~2model,the efficiency of Key-hole operation is?=0.853 and?=0.951 respectively,and ACDF operation is?=0.825 and?=0.872respectively.Conclusions:1.Key-hole and ACDF have significant curative effect in the early stage of cervical spondylotic radiculopathy,but there is no significant difference between them;2.Key-hole group is significantly better than ACDF group in terms of hospitalization days and treatment costs,and ACDF group has advantages over Key-hole group in terms of operation time;3.Based on the analysis of C~2R model and BC~2 model of DEA,the efficiency of Key-hole operation is better than ACDF operation;4.DEA,as a comprehensive evaluation method of multiple input and multiple output,is applicable in orthopedic surgery.