Clinical impact and imaging results after a modified procedure of ACDF: a prospective case-controlled study based on ninety cases with two-year follow-up

Abstract Study design This is a prospective case-controlled study. Background To analyze the postoperative axial pain and cage subsidence of patients presenting with cervical spondylotic myelopathy (CSM) after modified procedure ACDF (mACDF). Methods Ninety CSM were prospectively collected from 2014 to 2018. The divided into spread group non-spread (48:42 ratio) according placement or without releasing Caspar retractor decompression. Spread received conventional mACDF. Patients followed-up for at least 24 months surgery. Radiologic data, including height intervertebral space Cobb Angle, collected. Nervous system function was obtained using JOA scores, level assessed VAS scores. Results A total 90 enrolled ( n = 48) none-spread group( 42). Cage (spread vs group) (0.82 ± 0.68 0.58 0.81) mm, (0.64 0.77 0.34 0.46) (0.48 0.43 0.25 0.28) (0.45 0.47 0.17 0.32) mm 3 months, 6 12 respectively. period exhibiting most decrease postoperatively. However, there no statistical difference in space, scores final follow-up between two groups. Conclusions mACDF can avoid excessive distraction by Cervical retractor, restore “natural height” vertebra, relieve immediate surgery, prevent rapid loss curvature.