Tian Xiaoming, Zhao Hongwei, Han Felicity Y, Rudd Samuel, Li Zhaohui, Ding Wenyuan, Yang Sidong
Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Front Surg. 2022 Sep 16;9:1021643. doi: 10.3389/fsurg.2022.1021643. eCollection 2022.
This study aims to compare the outcomes between two anterior decompression and fusion techniques to treat multilevel cervical spondylotic myelopathy (MCSM).
After the screening for eligibility, a total of 66 patients were admitted to this study. These participants underwent anterior surgeries due to MCSM in our hospital between June 2016 and July 2018. All participants underwent either the anterior cervical discectomy and fusion (ACDF) surgery (ACDF group) or the combination of ACDF and anterior cervical corpectomy and fusion (ACCF), which was the anterior cervical hybrid decompression and fusion (ACHDF) surgery group. All the patients were followed up ≥18 months, the average latest followed up time was 23.64 (±2.69) months. The length of hospitalization, operation time, blood loss, visual analog scale (VAS), Japanese Orthopaedic Association (JOA) score, improvement rate, Hounsfield units (HU) of C3-C7, cobb angle, and anterior column height of fusion levels pre and post operation were analyzed.
There were no statistical differences between the ACDF and ACHDF groups regarding the length of hospitalization, operation time, blood loss, HU of C3-C7, VAS, JOA score, improvement rate, cobb angle, and anterior column height in fusion levels in pre-operation and 3 months after operation (all > 0.05). However, compared with the ACHDF group, the ACDF group achieved significantly better improvement in the anterior column height of fusion levels in the final 18-29 months post-operatively ( < 0.05).
Both approaches of ACDF alone and a combination of ACDF and ACCF can achieve satisfactory outcomes in the treatment of MCSM, but ACDF has better outcomes in maintaining anterior column height of fusion levels.
本研究旨在比较两种前路减压融合技术治疗多节段脊髓型颈椎病（MCSM）的疗效。
在筛选合格后，共有66例患者纳入本研究。这些参与者于2016年6月至2018年7月在我院因MCSM接受了前路手术。所有参与者均接受了颈椎前路椎间盘切除融合术（ACDF组）或ACDF与颈椎前路椎体次全切除融合术（ACCF）联合手术，即颈椎前路混合减压融合术（ACHDF）手术组。所有患者均随访≥18个月，平均末次随访时间为23.64（±2.69）个月。分析了住院时间、手术时间、失血量、视觉模拟评分（VAS）、日本骨科协会（JOA）评分、改善率、C3 - C7的亨氏单位（HU）、 Cobb角以及融合节段术前和术后的前柱高度。
ACDF组和ACHDF组在住院时间、手术时间、失血量、C3 - C7的HU、VAS、JOA评分、改善率、Cobb角以及术前和术后3个月融合节段的前柱高度方面均无统计学差异（均>0.05）。然而，与ACHDF组相比，ACDF组在术后最后18 - 29个月融合节段的前柱高度改善明显更好（<0.05）。
单独的ACDF以及ACDF与ACCF联合这两种方法在治疗MCSM方面均可取得满意的疗效，但ACDF在维持融合节段前柱高度方面具有更好的疗效。
