Abstract：
OBJECTIVE: To investigate the clinical effect of anterior cervical discectomy and fusion (ACDF) in the treatment of cervical spondylosis of vertebral artery type(CSA).
METHODS: The clinical data of 42 patients with CSA from January 2020 to January 2022 were retrospectively analyzed. There were 25 males and 17 females, aged from 30 to 74 years old with an average of (53.9±11.0) years old. There were 18 cases with single-segment lesions, 17 cases with two-segment lesions, and 7 cases with three-segment lesions. The American Academy of Otolaryngology-Head and Neck Surgery\'s Hearing and Balance Committee score (CHE), the Neck Disability Index (NDI) and the cervical curvature Cobb angle were recorded before surgery and after surgery at 6 months.
RESULTS: All 42 ACDF patients were followed up for 6 to 30 months with an average of (14.0±5.2) months. The operative time ranged from 95 to 220 min with an average of (160.38±36.77) min, the intraoperative blood loss ranged from 30 to 85 ml with an average of (53.60±18.98) ml. Tow patients had mild postoperative dysphagia, which improved with symptomatic treatment such as nebulized inhalation. CHE score decreased from (4.05±0.96) preoperatively to (2.40±0.70) at 6 months postoperatively (t=12.97, P<0.05). The number of improved vertigo at 6 months postoperatively was 38, with an improvement rate of 90.5%. NDI score was reduced from (34.43±8.04) preoperatively to (20.76±3.91) at 6 months postoperatively (t=11.83, P<0.05). The cervical curvature Cobb angle improved from (8.04±6.70)° preoperatively to (12.42±5.23)° at 6 months postoperatively (t=-15.96, P<0.05).
CONCLUSIONS: The ACDF procedure has outstanding clinical efficacy in treating CSA. The operation can rapidly relieve patients\' episodic vertigo symptoms by relieving bony compression and reconstructing cervical curvature. However, it is necessary to strictly grasp the indications for surgery and clarify the causes of vertigo in patients, and ACDF surgery is recommended for CSA patients for whom conservative treatment is ineffective.
METHODS: The clinical data of 42 patients with CSA from January 2020 to January 2022 were retrospectively analyzed. There were 25 males and 17 females, aged from 30 to 74 years old with an average of (53.9±11.0) years old. There were 18 cases with single-segment lesions, 17 cases with two-segment lesions, and 7 cases with three-segment lesions. The American Academy of Otolaryngology-Head and Neck Surgery\'s Hearing and Balance Committee score (CHE), the Neck Disability Index (NDI) and the cervical curvature Cobb angle were recorded before surgery and after surgery at 6 months.
RESULTS: All 42 ACDF patients were followed up for 6 to 30 months with an average of (14.0±5.2) months. The operative time ranged from 95 to 220 min with an average of (160.38±36.77) min, the intraoperative blood loss ranged from 30 to 85 ml with an average of (53.60±18.98) ml. Tow patients had mild postoperative dysphagia, which improved with symptomatic treatment such as nebulized inhalation. CHE score decreased from (4.05±0.96) preoperatively to (2.40±0.70) at 6 months postoperatively (t=12.97, P<0.05). The number of improved vertigo at 6 months postoperatively was 38, with an improvement rate of 90.5%. NDI score was reduced from (34.43±8.04) preoperatively to (20.76±3.91) at 6 months postoperatively (t=11.83, P<0.05). The cervical curvature Cobb angle improved from (8.04±6.70)° preoperatively to (12.42±5.23)° at 6 months postoperatively (t=-15.96, P<0.05).
CONCLUSIONS: The ACDF procedure has outstanding clinical efficacy in treating CSA. The operation can rapidly relieve patients\' episodic vertigo symptoms by relieving bony compression and reconstructing cervical curvature. However, it is necessary to strictly grasp the indications for surgery and clarify the causes of vertigo in patients, and ACDF surgery is recommended for CSA patients for whom conservative treatment is ineffective.
摘要：
目的：探讨颈椎前路椎间盘切除融合术(ACDF)治疗椎动脉型颈椎病(CSA)的临床疗效。
方法：回顾性分析2020年1月至2022年1月42例CSA患者的临床资料。有25名男性和17名女性，年龄30～74岁,平均(53.9±11.0)岁。单节段病变18例，17例两段病变，三段病变7例。美国耳鼻咽喉头颈外科学会的听力和平衡委员会评分（CHE），记录手术前和手术后6个月的颈部残疾指数（NDI）和颈椎曲度Cobb角。
结果：42例ACDF患者均获随访，随访时间6～30个月，平均(14.0±5.2)个月。手术时间95~220min,平均(160.38±36.77)min,术中出血量30～85ml,平均(53.60±18.98)ml。两名患者术后出现轻度吞咽困难，通过雾化吸入等对症治疗改善。CHE评分由术前（4.05±0.96）分下降至术后6个月（2.40±0.70）分（t=12.97，P<0.05）。术后6个月改善的眩晕数为38例,改善率为90.5%。NDI评分从术前（34.43±8.04）降低至术后6个月（20.76±3.91）（t=11.83，P<0.05）。颈曲度Cobb角由术前(8.04±6.70)°改善至术后6个月(12.42±5.23)°(t=-15.96,P<0.05)。
结论：ACDF治疗CSA的临床疗效突出。该手术可以通过减轻骨性压迫和重建颈椎曲度来迅速缓解患者的发作性眩晕症状。然而,有必要严格掌握手术指征，明确患者眩晕的原因，对于保守治疗无效的CSA患者，建议进行ACDF手术。
方法：回顾性分析2020年1月至2022年1月42例CSA患者的临床资料。有25名男性和17名女性，年龄30～74岁,平均(53.9±11.0)岁。单节段病变18例，17例两段病变，三段病变7例。美国耳鼻咽喉头颈外科学会的听力和平衡委员会评分（CHE），记录手术前和手术后6个月的颈部残疾指数（NDI）和颈椎曲度Cobb角。
结果：42例ACDF患者均获随访，随访时间6～30个月，平均(14.0±5.2)个月。手术时间95~220min,平均(160.38±36.77)min,术中出血量30～85ml,平均(53.60±18.98)ml。两名患者术后出现轻度吞咽困难，通过雾化吸入等对症治疗改善。CHE评分由术前（4.05±0.96）分下降至术后6个月（2.40±0.70）分（t=12.97，P<0.05）。术后6个月改善的眩晕数为38例,改善率为90.5%。NDI评分从术前（34.43±8.04）降低至术后6个月（20.76±3.91）（t=11.83，P<0.05）。颈曲度Cobb角由术前(8.04±6.70)°改善至术后6个月(12.42±5.23)°(t=-15.96,P<0.05)。
结论：ACDF治疗CSA的临床疗效突出。该手术可以通过减轻骨性压迫和重建颈椎曲度来迅速缓解患者的发作性眩晕症状。然而,有必要严格掌握手术指征，明确患者眩晕的原因，对于保守治疗无效的CSA患者，建议进行ACDF手术。
