The analysis of neck axial symptoms analysis after cervical artificial disc replacement and anterior cervical decompression and fusion

Abstract

Objective To compare the early clinical effects and neck axial symptom (AS)after cervical artificial disc replacement and anterior cervical discectomy and fusion,and to explore the value of cervical artificial disc lower the incidence of the postoperative neck AS.Methods To analyse the 86 cases of cervical spondylosis who treated in the first affiliated hospital of Zhengzhou university from August 2010 to February 2012 retrospectively,all of the cases were single segmental lesions.Forty-six patients (ACDF group) underwent anterior cervical discectomy and fusion,including 21 males and 25 females,with an average age of 51.6 years.Forty patients (ADR group) underwent cervical artificial disc replacement,including 18 males and 22 females,with an average age of 49.1 years.Through the observation of JOA scores,the satisfactory rate of Odom ' s scale,cervical curvature index(CCI),and the changes of cervical range of motion (ROM) of the two groups,to compare the incidence of neck AS of the two groups and analyzed the outcomes.Results All patients were followed up for 6 to 24 months,15.2 months on average.The patients' JOA scores at the postoperative follow-up increased obviously than preoperative (P ＜ 0.05).The satisfactory rate of Odom' s scale at 3,6 months and the final follow-up after operation showed no significant difference between the ACDF group and ADR group (P ＞ 0.05).In ACDF group,there was a significant loss of postoperative cervical curvature compared with preoperative (P ＜ 0.05),and there was no significant loss of the postoperative cervical curvature compared with preoperative (P ＞ 0.05) ; In ACDF group,the postoperative cervical ROM compared with preoperative reduced significantly (P ＜ 0.05),while the ADR group showed no significant difference (P ＞ 0.05).In ACDF group,the rate of postoperative AS was 47.83％,while 20.00％ in ADR group,it showed a significant difference between the two groups (P ＞0.05).Conclusions The artificial disc replacement can preserve cervical lordosis and cervical ROM,increase the activities of the adjacent segments,and do not need to wear a neck collar,and patients can exercise early,so it will reduce the occurrence of postoperative AS effectively. Key words: Cervical spondylosis; Artificial disc; Cervical curvature; Range of motion; Axial symptom