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Clinical effect of two anterior approaches to adjacent two-segment cervical spondylotic myelopathy

Yongning Li, Lin Gou, Yiguang Bai, Xuwei Luo, Wei Li, Liang Li

Objective: This paper discusses the clinical effects of two anterior approaches to adjacent two-segment Cervical Spondylotic Myelopathy (CSM).

Methods: A total of 108 patients with adjacent two-segment CSM who were admitted to our hospital from November 2015 to January 2017 were selected and divided randomly into control and observation groups according to different anterior approaches. The control group (46 cases) used single-segment Anterior Centrum Corpectomy Fusion (ACCF), whereas the observation group (62 cases) adopted twosegment Anterior Cervical Decompression and Fusion (ACDF). Indexes in perioperative period, visual analog scale score, JOA score, height of fused segment, and cervical curvature of the two groups were observed and compared.

Results: The observation group achieves a significant increase in the amount of bleeding and time of operation compared with the control group (P<0.05). No significant difference is found between the two groups in terms of length of stay (P>0.05). The observation group fails to achieve significant improvement compared with the control group in terms of VAS and JOA scores (P>0.05). By contrast, the observation group shows significant improvements in the height of fused segment and cervical curvature than the control group (P<0.05).

Conclusion: Reasonable selection of ACDF in clinical treatment of adjacent two-segment CSM can reduce the amount of bleeding during the operation significantly, thereby improving the cervical curvature and height of fused segment.