关键词: 脊髓型颈椎病, 融合, 疗效, 置换

Abstract: 【Abstract】 Objective To explore the clinical efficacy of cervical artificial disc replacement （CADR）and nterior cervical decompression and fusion（ACDF）in the treatment of single?segment cervical spondylotic myelopathy（CSM）. Methods From January 2015 to January 2018, 40 patients with single?segment CSM were enrolled, 19 of whom were treated with ACDF（ACDF group）and 21 with CADR （CADR group）. The patients in two groups were observed and followed before the surgery and 3 months, one year, 3 years after surgery. The JOA score, NDI score and the improvement rate of JOA score was recorded. The changes of MRI and X?ray images were examined. The effect of cervical decompression and fusion and the implant were observed and recorded. Results The clinical symptoms of the two groups were significantly relieved, and the neurological function was significantly improved. The JOA score and NDI score were statistically different between the two groups（P<0.05）. There was no significant difference in JOA scores between the ACDF group and the CADR group（P>0.05）, and the NDI scores in the CADR group were superior to the ACDF group（P<0.05）. The ACDF group had excellent JOA scores. The rate was 84%, and the CADR group was 90%. There was no statistically significant difference（P>0.05）. In the imaging findings, the success rate of fusion in the ACDF group was 94.7% at the last follow?up, and mild heterotopic ossification occurred in 2 patients in the CADR group, but the artificial intervertebral joint mobility was not significantly restricted. No serious postoperative complications occurred in either group. Conclusion Compared with the classic anterior fusion method, cervical artificial disc replacement can not only obtain the same excellent decompression effect, but also use the bionic prosthesis to maintain the original intervertebral activity, effectively avoiding the degeneration caused by peripheral bone joint compensation function increase because of fusion and a satisfactory short?term effect is obtained.

Key words: cervical spondylotic myelopathy, replacement, efficacy, fusion