Clinical study of double small incision ACDF in the treatment of the continuous 4-level cervical spondylotic myelopathy

ObjectiveTo explore the clinical efficacy of double small incision anterior cervical discectomy and fusion(ACDF) in the treatment of continuous 4-level cervical spondylotic myelopathy(CSM).

MethodsSeventy patients with CSM were divided into the double small incision group and single incision group according to the random number table method, and the double small incision group and single incision group were treated with the double small incision and traditional single incision ACDF, respectively.The surgical completion and follow-up complication rate in two groups were recorded, and the scores of the Japanese Orthopaedic Association(JOA), cervical total range of motion(ROM), cervical functional disability index(NDI) and visual analogue scale(VAS) were compared between two groups before surgery, after 3 months of surgery and at the last follow-up.

ResultsThere was no statistical significance in the operation time, incision length and bleeding volume between two groups(P>0.05).The incidence rate of complications in double small incision group was lower than that in single incision group(P < 0.01).There was no statistical significance in the VAS score, cervical ROM, NDI and JOA score between two groups at each observation time(P>0.05).The VAS score, cervical ROM and NDI in two groups gradually decreased before surgery, after 3 months of surgery and at the last follow-up(P < 0.01), and there was no statistical significance in the JOA score between two groups(P>0.05).

ConclusionsThe double small incision ACDF can achieve the same short-term efficacy as traditional single incision in the treatment of continuous 4-level CSM, but the double small incision ACDF can reduce the complications of anterior cervical surgery such as hoarse voice and dysphagia, which has certain application value.