Abstract:

Objective To compare the  long-term efficacies of anterior cervical decomprd 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 valuated with  American Spinal Injury Association(ASIA) score,Visual Analogue Scale (VAS),Japanese Orthopedics Association(JOA) score and imaging(Miyazaki grading system).Results107 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, theASIA, 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 discherniation.Long-term postoperative disc degeneration mainly occurrs in the upper segment.
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Key words: cervical vertebrae, diskectomy, adjacent segment, degeneration