Evaluation on efficacies of anterior cervical decompression and fusion and conservative therapy in treatment of unisegmental cervical disc herniation / 吉林大学学报(医学版)

ABSTRACT

Objective To compare the long-term efficacies of anterior cervical decompression and fusion (ACDF)and conservative therapy in treatment of unisegmental cervical disc herniation and to analyze the degree of the long-term adjacent segment disc degeneration in ACDF.Methods 120 patients treated in our hospital from January 2006 to January 2009 were selected,60 patients underwent ACDF as operation group and 60 patients underwent physical therapy and drug (conservative therapy)as non-operation group. All the patients were recorded when they were diagnosed with cervical unisegmental cervical disc herniation, and followed-up for 60 months, and they were evaluated with American Spinal Injury Association (ASIA)score,Visual Analogue Scale (VAS),Japanese Orthopedics Association (JOA) score and imaging (Miyazaki grading system). Results 107 patients were followed up,55 patients treated by operation were followed up for an average 59.7 months (59.7±0.4),while 52 patients treated by conservative therapy were followed up for an average 58.8 months (58.8±1.5).Compared with before treatment, the ASIA, JOA, and VAS scores of the patients in two group after treatment were improved (P<0.05),and the scores of ASIA,VAS,and JOA in operation group were superior to that in non-operation group (P<0.05),and adjacent segment disc degeneration occurred more frequently in the upper adjacent segment than the lower adjacent segment (P<0.05).Conclusion ACDF is superior to conservative therapy in alleviating symptoms and improving prognosis of unisegmental cervical disc herniation. Long-term postoperative disc degeneration mainly occurrs in the upper segment.