ZHANG Peng,SHEN Yong,CAO Junming.Axial symptoms after anterior cervical decompression and fusion for two-level cervical spondylotic myelopathy[J].Chinese Journal of Spine and Spinal Cord,2010,20(7):572-576.
Axial symptoms after anterior cervical decompression and fusion for two-level cervical spondylotic myelopathy
Received:April 14, 2010  Revised:June 07, 2010
English Keywords:Cervical spondylotic myelopathy  Anterior surgery  Axial symptom
Fund:河北省卫生厅重点资助项目(编号:20090124)
Author NameAffiliation
ZHANG Peng Department of Spine Surgerythe Third Hospital of Hebei Medical UniversityShijia-zhuang050051China 
SHEN Yong  
CAO Junming  
侯英诺  
徐佳欣  
丁文元  
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English Abstract:
  【Abstracts】 Objective:To investigate the incidence of axial symptoms(AS) after anterior cervical corpectomy and fusion(ACCF) and anterior cervical discectomy and fusion(ACDF) for 2-level cervical spondylotic myelopathy(CSM) respectively.Method:From March 2004 to May 2007,the clinical and radiographic data of 113 CSM patients with 2-level involvement treated surgically were collected,there were 61 cases(42 males and 19 females) with the mean age of 56.2 years(range,36-73 years) undergoing ACCF(group A),while 52(37 males and 15 females) with the mean age of 54.6 years(range,33-77 years) underwent 2-level ACDF(group B).The pre- and post-operative Japanese Orthopedic Association scores,segmental height and segmental lordosis were compared between each group.And the incidence of postoperative AS was analyzed either.Result:All patients were followed up for an average of 32.2 months(range,24-48months).The improving rate of neurological function at final follow-up was (70.1±12.2)% and (63.5±4.7)% for group A and B respectively,with no significant difference(P>0.05).However the change of fusion segments height was -0.04±0.02cm and 0.05±0.02cm,with significant difference(P<0.05).Kyphosis rate for fusion segments was 34.4% and 13.5%,with significant difference(P<0.05).The incidence of AS at final follow-up was 45.9%(28/61) and 26.9%(14/52) for group A and B respectively,with significant difference(P<0.05).The prevalence of AS complicated with lowering of fusion segments height was higher than that with no lowering of fusion segments height(P<0.05),and the lowering of fusion segments height in group A was higher than that in group B(P<0.05).The prevalence of AS complicated with severe kyphosis in group A was higher than that with no or mild kyphosis(P<0.05),and the prevalence of severe kyphosis in fusion segments in group A was higher than that in group B(P<0.05).Conclusion:The incidence of the postoperative AS is much higher in patients complicated with decreased fusion segments height and/or with obvious kyphosis after anterior cervical decompression and fusion.Compared with ACCF,ACDF for CSM is associated with good outcomes and lower incidence of the postoperative AS.
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