Comparative Study on Efficacy in Treatment of Double-Segmental Cervical Spondylosis with Two Anterior Surgical Approaches

Wang Xinyang; Wang Yingfeng; Han Jianbang; Li Yi; Huang Dingan

Abstract：Objective To compare efficacy of anterior cervical discectomy and fusion(ACDF)and anterior cervical corpectomy and fusion(ACCF)in treatment of double-segmental cervical spondylosis.Methods 102 patients underwent surgical treatment for double-segmental cervical spondylosis in Peoples'Hospital of Huangshan City from January 2018 to June 2022 were retrospectively reviewed,and divided into ACDF group and ACCF group,according to surgical approach the patient received.ACDF group comprised 50 patients(22 males and 28 females),mean age of(54.78±10.22)years.ACCF group included 52 patients(40 males and 12 females),mean age of(56.06±10.32)years.Perioperative indexes,incidence rate of complications,excellent and good rate,visual analogue scale(VAS),Japan orthopaedic association(JOA)score,neck disability index(NDI),cervical Cobb angle,cervical range of motion(ROM),ROM of adjacent upper and caudal segments,incidence rate of adjacent segment degeneration(ASD)were compared between the two groups.Results There was no significant difference in preoperative VAS,JOA score,NDI between the two groups(P＞0.05).Operation time,intraoperative blood loss,drainage volume,hospital stay and incidence rate of complications in ACDF group were significantly less than those in ACCF group(P＜0.05).All of the patients were followed up for 15 to 22 months with a mean time of(18.23±1.50)months.VAS,JOA score,NDI improved significantly in both groups(P＜0.05),but there was no significant difference in excellent and good rate,cervical ROM,ROM of adjacent upper and caudal segments and incidence rate of ASD between the two groups at final follow-up(P＞0.05).The cervical Cobb angle in ACDF group was significantly larger than that in ACCF group(P＜0.0 5).Conclusion Both ACDF and ACCF produce a satisfactory operative efficacy in treatment of double-segmental cervical spondylosis,improving cervical and nervous function.However,both two approaches may lead to complications and ASD,partly restrict cervical movement.Comparatively,ACDF is less invasive,causes fewer complications and maintains better cervical curvature.