Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai 200003, China.
Eur Spine J. 2012 Jul;21(7):1368-73. doi: 10.1007/s00586-012-2157-7. Epub 2012 Jan 20.
Anterior cervical decompression and fusion (ACDF) procedures are successful in treating multilevel cervical radiculopathy and cervical myelopathy. It was reported that this procedure would result in a loss of cervical range of motion. However, few studies have focused on the exact impact of multilevel (more than 3 levels) ACDF on cervical range of motion.
29 patients underwent a 3-level or 4-level ACDF. In all the patients, preoperative active cervical ROM measurement was performed, and postoperative measurement was performed at 1-year follow-up by a CROM device. The pre- and postoperative data were compared to each other using paired t tests (α = 0.05).
The patients had significantly less ROM after the surgery in all planes of motion. Major reduction was observed in flexion (39.5%), left and right lateral flexion (25.7 and 25.9%), with relatively minor impact on extension (18.3%), left and right rotation (14.0 and 14.4%) observed. In the three cardinal planes, major reduction was observed in the sagittal plane (28.2%) and coronal plane (25.8%), while minor impact observed in the horizontal plane (14.1%).
The patients of cervical spondylotic myelopathy had an obvious reduction in active cervical ROM following multilevel ACDF. However, patients might not experience great difficulties in performing daily activities with regard to the loss of neck motion after fusion.
颈椎前路减压融合术（ACDF）在治疗多节段颈椎病神经根病和颈椎病脊髓病方面取得了成功。据报道，该手术会导致颈椎活动度丧失。然而，很少有研究关注多节段（超过 3 个节段）ACDF 对颈椎活动度的确切影响。
29 例患者接受了 3 节段或 4 节段 ACDF。所有患者均在术前进行主动颈椎 ROM 测量，并在术后 1 年通过 CROM 装置进行术后测量。使用配对 t 检验（α=0.05）对术前和术后数据进行比较。
患者在所有运动平面的 ROM 均显著减少。屈伸（39.5%）、左右侧屈（25.7%和 25.9%）明显减少，伸展（18.3%）、左右旋转（14.0%和 14.4%）相对较小。在三个主要平面中，矢状面（28.2%）和冠状面（25.8%）明显减少，而水平面（14.1%）减少较小。
多节段 ACDF 后，颈椎病脊髓病患者的主动颈椎 ROM 明显减少。然而，对于融合后颈部运动丧失，患者可能不会在进行日常活动时感到困难。
