单节段ACDR与ACDF治疗伴可复性反弓颈椎病的疗效比较

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Abstract Objective To compare the clinical and radiological outcomes of single-level artificial cervical disc replacement (ACDR) and single-level anterior cervical discectomy and fusion (ACDF) in patients with preoperative reversible kyphosis (RK).Methods Twenty-seven ACDR patients (male/female：14/13) with a mean age of (42.3±6.9)years (range，37~51 years) and 29 ACDF patients (male/female：12/17) with a mean age of (43.7±7.6)years (range，38~53 years) were included.The Japanese orthopedic association(JOA) score，neck disability index(NDI)，and visual analogue scale(VAS) were used to evaluate clinical outcomes.Range of motion(ROM)，the segmental angle at the index level，C_2~7 angle，functional spinal unit(FSU) angle，adjacent segment degeneration(ASD)，and heterotopic ossification(HO) were assessed.Results The follow-up averaged (40.6±10.4)months (range，25~66 months) in ACDR and (39.7±9.5)months(range，21~63 months) in ACDF.Both groups had significant improvements in clinical outcomes without significant intergroup differences.Compared with preoperative values，C_2~7 angle and FSU increased significantly in both groups，while the C_2~7 ROM was preserved.At the last follow-up，the C_2~7 angle，FSU，and C_2~7 ROM remained comparable between groups.The ACDR group had a significantly higher segmental ROM at the surgical level than ACDFgroup.Three ASD cases were noticed in ACDR group，while 5 cases were observed in ACDF group.According to McAfee classification，59.3%(16/27) ACDR patients developed HO (5 cases of grade Ⅲ；2 cases of grade Ⅳ).Conclusion Both ACDR and ACDF have satisfactory clinical results for the treatment of single-level disc degenerative disease with preoperative RK.ACDR is non-inferior to ACDF regarding the radiological outcomes of cervical alignment.ACDR group had a relatively high incidence of HO formation.

Key words： artificial cervical disc replacement anterior cervical discectomy and fusion reversible kyphosis pcervical spondylosis

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