Shaker Ahmed Saleh, Addosooki Ahmad I, El-Deen Mohamed Alam
Department of Orthopedic Surgery, Sohag University, Sohag, Egypt.
Int J Spine Surg. 2015 Nov 12;9:60. doi: 10.14444/2060. eCollection 2015.
A retrospective study to compare the radiologic and clinical outcomes of 2 different anterior approaches, multilevel anterior cervical discectomy with fusion (ACDF) using autologus ticortical bone graft versus anterior cervical corpectomy with fusion (ACCF) using free vascularized fibular graft (FVFG) for the management of cervical spondylotic myelopathy(CSM).
A total of 15 patients who underwent ACDF or ACCF using FVFG for multilevel CSM were divided into two groups. Group A (n = 7) underwent ACDF and group B (n = 8) ACCF. Clinical outcomes using Japanese Orthopaedic Association (JOA) score, perioperative parameters including operation time and hospital stay, radiological parameters including fusion rate and cervical lordosis, and complications were compared.
Both group A and group B demonstrated significant increases in JOA scores. Patients who underwent ACDF experienced significantly shorter operation times and hospital stay. Both groups showed significant increases in postoperative cervical lordosis and achieved the same fusion rate (100 %). No major complications were encountered in both groups.
Both ACDF and ACCF using FVFG provide satisfactory clinical outcomes and fusion rates for multilevel CSM. However, multilevel ACDF is associated with better radiologic parameters, shorter hospital stay and shorter operative times.
一项回顾性研究，比较两种不同前路手术的放射学和临床结果，即采用自体皮质骨移植的多节段颈椎间盘切除融合术（ACDF）与采用游离血管化腓骨移植（FVFG）的颈椎椎体次全切除融合术（ACCF）治疗脊髓型颈椎病（CSM）。
共有15例接受FVFG的ACDF或ACCF治疗多节段CSM的患者被分为两组。A组（n = 7）接受ACDF，B组（n = 8）接受ACCF。比较使用日本骨科学会（JOA）评分的临床结果、包括手术时间和住院时间的围手术期参数、包括融合率和颈椎前凸的放射学参数以及并发症。
A组和B组的JOA评分均显著提高。接受ACDF的患者手术时间和住院时间明显更短。两组术后颈椎前凸均显著增加，融合率相同（100%）。两组均未出现重大并发症。
采用FVFG的ACDF和ACCF对多节段CSM均提供了满意的临床结果和融合率。然而，多节段ACDF具有更好的放射学参数、更短的住院时间和更短的手术时间。
