Microsurgery anterior cervical discectomy and fusion for cervical degenerative diseases with bony compression

doi:10.3969/j.issn.2095-4344.0329

Abstract

Abstract:

BACKGROUND: Anterior cervical discectomy and fusion (ACDF), is a classic treatment of cervical degenerative diseases, but narrow surgical field and difficult bone decompression often result in insufficient decompression. Spinal microscope with high magnification making the surgical field clear has its unique advantage during ACDF.

OBJECTIVE: To compare the clinical outcomes of microsurgery ACDF (MACDF) and ACDF for cervical degenerative diseases, so as to investigate the clinical results of microsurgery.

METHODS: Forty-one patients from June 2015 to June 2016 were enrolled, 24 patients underwent MACDF, and 17 patients underwent ACDF. The osteophyte of spinal canal of cervical was measured on CT, and then the spinal canal occupation ratio was calculated. The Japanese Orthopedic Association (JOA) scoring system was used to evaluate the neurological status at 1 week, 3, 6 and 12 months postoperatively, and the JOA recovery rate was calculated. The incision length, intraoperative blood loss and postoperative volume of drainage were recorded and compared.

RESULTS AND CONCLUSION: (1) According to preoperative data, the two groups did not differ with respect to age, sex, level of radiculopathy and preoperative JOA score. (2) Compared with the ACDF group, the postoperative spinal canal occupation ratio was significantly decreased, the JOA scores and JOA recovery rate at 1 week, 3, 6 and 12 months postoperatively were significantly improved, and the incision length, intraoperative blood loss and postoperative volume of drainage were significantly reduced in the MACDF group (P < 0.05). (3) There were two (8%) cases of dysphagia in the MACDF group. In the ACDF group, there were two (12%) cases of dysphagia, one (6%) case of hoarseness, and two cases (12%) of skin hematoma. The incidence of complications did not differ significantly between groups (P > 0.05). (4) To conclude, the MACDF is restored significantly than ACDF in bleeding volume, the incision length and efficacy of bone decompression, which are in accordance with the principle of minimally invasive surgery.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Spinal Fusion, Cervical Vertebrae, Surgical Procedures, Minimally Invasive, Tissue Engineering

CLC Number:

R318

Wo Jin, Yuan Feng. Microsurgery anterior cervical discectomy and fusion for cervical degenerative diseases with bony compression[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(23): 3621-3627.

Figures/Tables 3

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