Author:
Wu Zhi-Peng,Wei Zhao-yong,Song Xiao-Lei
Abstract
Abstract
Background
In this study, we compared the clinical efficacy of endoscope-assisted anterior cervical discectomy and fusion (ACDF) with open ACDF in the treatment of single-segment cervical spondylotic myelopathy.
Methods
A retrospective analysis was performed on 52 patients with single-segment cervical spondylotic myelopathy between June 2021 and February 2022, including 33 males and 19 females, with a mean age of 58.42 ± 9.26) years. Among them, 28 patients were treated with endoscope-assisted ACDF (Group A), including 2 cases of C4/5 segment, 16 cases of C5/6 segment, and 10 cases of C6/7 segment; 24 patients were treated with open ACDF (Group B), including 4 cases of C4/5 segment, 11 cases of C5/6 segment, and 9 cases of C6/7 segment. The operation time, intraoperative blood loss, hospital stay, and complications were recorded and compared between the two groups. The Visual Analogue Scale (VAS) and the Japanese Orthopaedic Association (JOA) score were used for clinical evaluation during the follow-up in the 1st month and 3rd month after surgery, and at the final follow-up.
Results
The 52 patients were followed up on average for 13.04 months (12–17 months). The operation time in Group A and Group B was (105.18 + 8.66) minutes and (81.88 + 6.05) minutes, the intraoperative blood loss was (84.29 + 13.45) mL and (112.92 + 17.81) mL, and the hospital stay was (6.75 + 1.29) days and (7.63 + 1.41) days, respectively. The difference between the two groups was statistically significant (P < 0.05). The VAS and JOA scores in the 1st month and the 3rd month after surgery and the last follow-up significantly improved in both groups compared with those before surgery (P < 0.05). The VAS and JOA scores of Group A in the 1st month, 3rd month after surgery, and the last follow-up were better than those in Group B (P < 0.05). The complication rate in Group A was 7% (2/28), which was not significantly different from the 17% (4/24) in Group B (P > 0.05).
Conclusion
Both endoscope-assisted ACDF and open ACDF can achieve satisfactory clinical efficacy in the treatment of single-segment cervical spondylotic myelopathy. Although the operation time of endoscope-assisted ACDF is prolonged, it has the advantages of clear vision, thorough decompression, less blood loss, and reduced risk of nerve damage, and is worthy of clinical promotion and application.
Publisher
Springer Science and Business Media LLC
Reference22 articles.
1. Donnally CJ 3rd, Patel PD, Canseco JA, Vaccaro AR, Kepler CK. Current management of cervical spondylotic myelopathy. Clin Spine Surg. 2022;35(1):E68–76.
2. McCormick JR, Sama AJ, Schiller NC, Butler AJ, Donnally CJ 3rd. Cervical spondylotic myelopathy: a guide to diagnosis and management. J Am Board Fam Med. 2020;33(2):303–13.
3. Lee CJ, Boody BS, Demeter J, Smucker JD, Sasso RC. Long-term radiographic and functional outcomes of patients with absence of radiographic union at 2 years after single-level anterior cervical discectomy and fusion. Global Spine J. 2020;10(6):741–7.
4. Luo HT, Cheng ZY, Lv SG, Xiao JX, He W, Huang K, Fan YH, Zhu XG. Meta-analysis of the treatment of cervical spondylosis by microscopy-assisted and traditional anterior cervical decompression under direct vision. Chin J Tissue Eng Res. 2020;24(9):7.
5. Barbagallo GMV, Certo F. Three-dimensional, high-definition exoscopic anterior cervical discectomy and fusion: a valid alternative to microscope-assisted surgery. World Neurosurg. 2019;130:e244–50.