| Objective To compare the clinical effect of new anterior cervical zero-profile anchored spacer (ROI-C) implantation and interbody fusion cage combined with anterior titanium plate fixation in the treatment of multilevel cervical spondylotic myelopathy (MCSM). Methods The clinical data of 76 patients with MCSM who were treated in Orthopedics Department, the First Affiliated Hospital of Henan University, between July 2014 and January 2019 were analyzed. All patients were treated with cervical anterior discectomy decompression and bone graft fusion internal fixation. According to different fixation methods in surgery, the patients were divided into ROI-C group (35 cases treated with fixation of ROI-C) and the control group (41 cases treated with fixation of interbody fusion cage and anterior titanium plate). The surgical parameters such as surgical time, frequency of intraoperative fluoroscopy, blood loss and complications were recorded. The surgical effects were evaluated by Japanese Orthopaedic Association (JOA) and visual analogue scale (VAS) scores 1 week, 3 months, 6 months after surgery. Results Compared with control group, the surgical time was significantly shorter, the frequency of intraoperative fluoroscopy and blood loss were significantly less in ROI-C group (P<0.05). There was no significant difference in postoperative hospital stay, incidence of infection, hematoma, nerve injury or esophageal injury between the two groups (P>0.05). The incidence of swallowing discomfort in ROI-C group was only 2.86%, significantly lower than that in control group (19.51%) (P<0.05). 1 week, 3 months and 6 months after surgery, JOA scores of the two groups significantly increased in turn, while VAS scores significantly decreased in turn (P<0.05). 3 months and 6 months after surgery and in the last follow-up, cervical physiological curvature and height of intervertebral space were significantly higher than those before surgery (P>0.05). However, there was no significant difference in JOA scores, VAS scores, cervical physiological curvature or height of intervertebral space between ROI-C group and control group before and after surgery (P>0.05). Conclusions The curative effects of both ROI-C implantation and interbody fusion cage combined with anterior titanium plate surgery are satisfactory in the treatment of MCSM. They are conductive to the recovery pf cervical physiological curvature and height of intervertebral space. However, the former is with advantages such as simple operation, short duration, little intraoperative fluoroscopy and blood loss, and low incidence of postoperative swallowing discomfort. So, it can be the priority. |
