Anterior combination of non-fusion and fusion approach for cervical spondylosis

English Keywords:Cervical spondylosis  Decompression  Fusion  Non-fusion

English Abstract:

  【Abstract】 Objectives: To observe the clinical outcome of anterior combination of non-fusion and fusion approach for cervical spondylosis. Methods: Twenty-eight cases with cervical spondylosis(CS) undergoing combination of anterior cervical discectomy and fusion(ACDF) and cervical artificial disc replacement(C-ADR) between March 2008 and June 2010 were reviewed. Two levels of intervertebral discs were involved in 19 cases, while three levels were involved in 9 cases. The levels of fusion and non-fusion were adjacent in 24 cases while not adjacent in 4 cases. Preoperative and follow-up JOA scores and neck disability index(NDI) were utilized. Clinical results were evaluated according to the Odom standard． Preoperative, immediate postoperative and follow-up X-rays were used to evaluate the bony fusion and instrumentation. Results: All the operations were completed successfully. The operation time was 85min in average(from 70 to 150min), and the amount of bleeding was 180ml in average(from 50 to 300ml). 1 case who had a slight dyspnea was improved gradually after symptomatic treatment. The wounds were all healed at stage Ⅰ. There was no damage of vertebral artery or recurrent laryngeal nerve. All of the 28 cases were followed up for 14-39 months(average, 22 months). No autograft or instrument failure was found. Time for bony fusion was 3-8 months(average, 4.5 months). All the cervical artificial discs had good motor function. Preoperative JOA score was 10.3, which significantly increased to 13.8 at final follow-up. Preoperative NDI score was 38.5, which significantly decreased to 22.3 at final follow-up(P＜0.01). Odom standard at final follow-up showed 14 excellent, 8 good, 5 fair and 1 poor. Conclusions: Anterior combination of non-fusion and fusion approach is reliable for decompression as well as shortening fusion segments.