Objective To compare the differences of therapeutic effects between anterior corpectomy interbody fusion combined with titanium plate internal fixation operation (ACCF) and anterior cervical discectomy interbody fusion combined with titanium plate internal fixation operation(ACDF) on adjacent two segmental cervical spondylotic myelopathy.Methods The clinical data about 80 patients with adjacent two segmental cervical spondylotic myelopathy who received surgical treatment in our hospital from January 2011 to January 2016 were retrospectively analyzed,in whom,40 patients were treated by ACDF (group A),the other 40 patients were treated by ACCF (group B).The surgical duration, intraoperative bleeding volume, postoperative hospitalization time,postoperative fusion rate,neurological function,pain degree,fusion segments Cobb angle, surgical segment anterior salient angle were observed and compared between two groups. Results The surgical duration, intraoperative bleeding volume, postoperative hospitalization time in group A were significantly lower than those in group B (P<0.05),however, there was no significant difference in postoperative fusion rate between two groups (P>0.05). The JOA scores on 1m,6m after operation were significantly increased in both groups, as compared with those before operation (P<0.05),however,the VAS scores on 1m,6m after operation were significantly decreased in both groups,as compared with those before operation (P<0.05).Moreover there were no significant differences in Cobb angle and surgical segment anterior salient angle before operation, on 6m after operation between two groups (P>0.05).Conclusion ACDF in treatment of adjacent two segmental cervical spondylotic myelopathy has the advantages of shorter operation time, less intraoperative bleeding volume and reliable therapeutic effects.%目的 探讨相邻双节段脊髓型颈椎病患者采用前路椎体次全切植骨融合并钛板置入内固定术(ACCF)、前路椎间盘切除植骨融合并钛板置入内固定术(ACDF)治疗的效果差异.方法 选取2011年1月至2016年1月手术治疗的80例相邻双节段脊髓型颈椎病患者进行回顾性分析,其中40例患者采用ACDF治疗(A组)、40例患者采用ACCF治疗(B组),对比2组手术时间、手术出血量、住院时间、术后融合率、神经功能、疼痛程度、融合节段Cobb角、手术节段前凸角.结果 A组患者的手术时间、手术出血量、住院时间均低于B组(P<0.05);2组患者的术后融合率比较差异无统计学意义(P>0.05);术后1个月、6个月,2组患者的JOA评分较本组术前均显著的升高(P<0.05);术后1个月、6个月,2组患者的VAS评分较本组术前均显著的降低(P<0.05);术前、术后6个月,A组患者组间术前Cobb角、手术节段前凸角与B组比较,差异无统计学意义(P>0.05).结论 ACDF治疗相邻双节段脊髓型颈椎病患者具有手术时间短、出血量少、手术效果可靠的特点.
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