Analysis Of The Clinical Effect Of Modified Anterior Controllable Antidisplacement And Fusion In The Treatment Of Multi Segment Cervical Spondylotic Myelopathy

Objective: To investigate the clinical effect of modified anterior controllable antidisplacement and fusion(ACAF)in the treatment of multi segment cervical spondylotic myelopathy(MCSM).Methods: The clinical records of patients with multi segmented cervical myelopathy treated with modified ACAF in our hospital from October 2018 to February 2022 were collected,and a total of 21 patients,including 14 males and 7 females,aged 47-75 years,with a mean of60.3.The basic data of the patients,including age,gender,duration of symptoms,duration of surgery,duration of hospital stay,and intraoperative blood loss,were recorded.Neurological function and pain were assessed by the Japanese Orthopaedic Association(JOA)score and Visualanalogue scale(VAS)score before and at follow-up(6 months after operation);The curvature of the cervical spine,sagittal diameter of the spinal canal,cross-sectional area of the spinal canal,spinal cord area and cerebrospinal fluid area were measured before and after surgery,and the width of decompression of each vertebral body after surgery as well as the status of interbody bone graft fusion were assessed.The height of the intervertebral space involving each vertebral body,the distance between the anterior angles of the uncinates,the distance from the anterior angle of the uncinates to the transverse foramen,and the size of the compacts were measured preoperatively by 3D modeling software;Postoperative complications were also observed: hematoma of incision,infection of incision,spinal cord injury,cerebrospinal fluid leakage and other conditions.Results: All 21 patients in our series successfully completed the procedure,and only one patient developed a postoperative CSF leak.At the time of postoperative follow-up,the JOA score and VAS score were significantly improved compared with the preoperative values(P<0.05).The curvature of the cervical spine,the sagittal diameter of the spinal canal,the cross-sectional area of the spinal canal and the areas of the spinal cord and cerebrospinal fluid increased significantly(P<0.05)after surgery,all patients had solid fusion,lateral radiographs showed no displacement of the internal plant,a bone bridge was formed between the vertebral body and the bone graft block,and the plate screws were fixed in position,and the vertebral body showed no sinking.Conclusions: The modified ACAF technique achieved satisfactory clinical outcomes in the treatment of multisegment cervical spondylotic myelopathy,and is one of the safe and effective procedures for the treatment of MCSM,reducing patient medical expenses while increasing the interbody fusion rate and relatively high patient satisfaction.