Etemadifar Mohammadreza, Andalib Ali, Shafiee Hossein, Samani Milad Kabiri
Department of Orthopedic Surgery, Al Zahra Educational Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
J Craniovertebr Junction Spine. 2018 Jul-Sep;9(3):170-174. doi: 10.4103/jcvjs.JCVJS_74_18.
Anterior cervical discectomy and fusion (ACDF) surgery is an accepted method for many spinal cord abnormalities. The purpose of this study was to evaluate the outcomes of treating patients with spinal cord lesions at one level or two levels through ACDF with cage-stand-alone (ACDF-CA) and ACDF with cage-with-plate fixation (ACDF-CP) surgery and comparing these results with each other.
In this prospective, cross-sectional, descriptive study, eighty patients undergoing ACDF surgery were enrolled according to the inclusion and exclusion criteria. Demographic data, before and after surgery findings, and clinical symptoms were investigated. Data were collected by means of visual analog scale (VAS) and Neck Disability Index (NDI) questionnaires. The adverse effects and surgical outcomes were evaluated based on Odom's criteria and patients' satisfaction. The collected data of the groups were then compared and assessed.
There was no significant difference between the groups in regards of gender, age, duration of surgery to visit, surgical level, preoperative and postoperative VAS and cervical range of motion, preoperative NDI, results based on Odom's criteria, and satisfaction of patients ( > 0.05). The VAS, NDI, and range of motion scores were significantly reduced in the four groups after the operation compared to the preoperative stage. Postoperative NDI scores in the ACDF-CA group at one level were significantly lower than other groups ( < 0.05).
Both of the methods revealed acceptable outcomes in comparison to the preoperative stage, and despite some minor differences, there are generally no significant differences in outcomes and complications.
颈椎前路椎间盘切除融合术（ACDF）是治疗多种脊髓异常的一种公认方法。本研究的目的是评估通过单独椎间融合器（ACDF-CA）和带钢板固定椎间融合器（ACDF-CP）的ACDF手术治疗单节段或双节段脊髓损伤患者的疗效，并比较这些结果。
在这项前瞻性、横断面、描述性研究中，根据纳入和排除标准招募了80例行ACDF手术的患者。调查了人口统计学数据、手术前后的检查结果和临床症状。通过视觉模拟量表（VAS）和颈部功能障碍指数（NDI）问卷收集数据。根据奥多姆标准和患者满意度评估不良反应和手术结果。然后对各组收集的数据进行比较和评估。
两组在性别、年龄、手术至就诊时间、手术节段、术前和术后VAS及颈椎活动范围、术前NDI、基于奥多姆标准的结果以及患者满意度方面无显著差异（P>0.05）。与术前相比，四组术后VAS、NDI和活动范围评分均显著降低。单节段ACDF-CA组术后NDI评分显著低于其他组（P<0.05）。
与术前相比，两种方法均显示出可接受的结果，尽管存在一些细微差异，但总体上结果和并发症无显著差异。
