Mid-Term Functional Recovery After ACDF and ACCF in the Treatment of Adjacent Two-Level Cervical Spondylosis: A Comparative Study.

Objective: This study aims to comparatively analyze the mid-term functional recovery following anterior cervical discectomy and fusion (ACDF) versus anterior cervical corpectomy and fusion (ACCF) in the treatment of adjacent two-level cervical spondylosis.

Methods: A retrospective analysis was conducted on the medical records of 123 patients with adjacent two-level cervical spondylosis treated at our hospital between January 1, 2018, and June 30, 2022. The patients were divided into the ACCF group (n=63) and the ACDF group (n=60) according to the surgical method. The clinical outcomes, surgical details, mid-term functional recovery, cervical Cobb angle (C2-7), overall cervical range of motion (ROM) (C2-7), adjacent segment ROM (upper and lower adjacent segments), and incidence of complications were compared between the two groups before surgery and at the final follow-up.

Results: Preoperatively, there were no significant differences between the groups in JOA, VAS, and NDI scores (P > 0.05). The ACDF group had shorter operative time, less intraoperative blood loss, and lower postoperative drainage volume compared to the ACCF group (P < 0.05). The incidence of postoperative complications was also lower in the ACDF group (P < 0.05). At 18 months postoperatively, both groups showed significant improvement compared to their preoperative status (P < 0.05), with no significant differences in the rate of excellent and good outcomes between the two groups (P > 0.05). There were no significant differences between the groups in terms of cervical Cobb angle, overall cervical ROM, or ROM of the upper and lower adjacent segments (P > 0.05). Additionally, there was no significant difference in the incidence of adjacent segment degeneration between the two groups (P > 0.05).

Conclusion: Both ACDF and ACCF are effective surgical options for patients with adjacent two-level cervical spondylosis, improving cervical function and alleviating pain. However, both procedures are associated with a certain incidence of complications and a reduction in cervical mobility postoperatively. Comparatively, ACDF offers advantages in terms of shorter operative time, less intraoperative blood loss, and lower postoperative drainage volume.