混合型颈椎后纵韧带骨化症的手术治疗

[目的]探讨混合型颈椎后纵韧带骨化症手术治疗的疗效及影响预后的相关因素分析.[方法]自2003年6月～2007年6月共收治混合型颈椎后纵韧带骨化症患者42例,其中18例行颈后路单开门椎管成型锚钉内固定,15例行后路单开门椎管成型丝线固定术、9例行单纯后路椎板切除椎管减压术,对手术前后JOA评分、颈肩痛及预后的影响因素进行随访观察.[结果]随访6个月～4年(平均23个月),42例患者均获随访,锚钉内固定组、丝线固定组、单纯减压组术前术后各组手术前后评分之间存在显著性差异(t检验,P<0.05).术后颈肩部疼痛评分锚钉内固定组优于其他两手术组(q检验,P<0.05).颈椎节段最大活动度、活动节段最小残留率、脊髓膨胀率与JOA评分改善率之间存在线性相关.[结论]后路椎板成型和椎板减压是治疗混合型OPLL的有效方案;颈椎节段最大活动度、活动节段最小残留率、脊髓膨胀率与JOA评分改善率之间存在相关性;锚钉内固定对术后颈肩痛的预防有一定作用.     

前路减压植骨内固定术治疗多节段颈椎病的临床分析

[目的]探讨多节段颈椎病前路椎间盘切除减压植骨内固定术的临床应用价值。[方法]对30例多节段颈椎病患者,采用前路多节段椎间盘切除减压植骨内固定术治疗,观察患者临床表现、神经功能改善、椎间隙高度、颈椎生理曲度恢复和矫形重建。[结果]所有患者术后JOA评分均有改善,颈椎Cobb角、D值和椎间高度术后与术前比较均有显著性差异(P<0.01)。术后X线片均显示融合节段融合。[结论]多节段颈椎病如果致压物来自前方,没有后纵韧带骨化,经前路多节段椎间盘切除减压植骨内固定术治疗,临床效果满意。     

严重颈椎后纵韧带骨化症前路和后路手术比较

目的 探讨前路和后路手术治疗严重颈椎后纵韧带骨化症的适应证选择、疗效及并发症.方法 2004年1月至2006年12月,手术治疗椎管狭窄率大于50%的严重颈椎后纵韧带骨化症患者34例(男29例,女5例,平均57.2岁),前路采用椎体次全切除减压钛网植骨内固定术14例(男12例,女2例),后路采用椎板切除减压侧块螺钉固定术20例(男17例,女3例).比较两种手术方式患者的颈椎管矢状径、颈椎曲度、椎管狭窄率、骨化物分型、骨化物范围、脊髓压迫率等的差异.采用JOA评分评价患者术前、术后神经功能,并计算改善率.结果 影像学结果显示前路手术主要为范围在3个节段以内的局限型和分节型骨化患者,而后路手术主要为范围超过3节段的连续型和混合型骨化患者,骨化物的分型及范围是选择的主要依据.所有患者随访6个月～3年,平均1.5年.前路手术组JOA评分从术前平均(9.3+1.8)分提高至术后平均(14.2±1.3)分,平均改善率62.3%±15.2%;后路手术组JOA评分从术前平均(8.7+1.6)分提高至术后平均(11.4±1.2)分,平均改善率33.5%±12.7%.两组患者疗效差异有统计学意义(P＜0.01).结论 对于骨化范围在3个节段以内的患者,前路手术是安全、有效的治疗方式,而后路手术则适用于范围超过3个节段的严重颈椎后纵韧带骨化症患者.     

后路单开门椎管成形术与全椎板切除减压术治疗颈椎后纵韧带骨化症的对比研究

[目的]探讨颈椎后路单开门微型钛板内固定椎管成形术与全椎板切除减压侧块螺钉内固术治疗颈椎后纵韧带骨化症的临床效果。[方法]入选80例颈椎后纵韧带骨化症患者,随机分为单开门组和全椎板切除组,实施减压内固定术。术后随访时间为12~24个月。从手术时间、术中失血量、颈椎曲度指数丢失度、脊髓后移距离、颈椎活动丢失角度、神经功能改善率及并发症等几个方面比较两组的临床效果。[结果]单开门组在手术时间、术中透视时间、术中出血量等方面明显少于全椎板切除组;在脊髓后移距离、颈椎曲度指数、颈椎活动丢失角度等方面少于全椎板切除组。两组在神经功能改善率及并发症发生率方面无显著差异。[结论]后路单开门钛板内固定椎管扩大成形术,手术操作简单,创伤小,疗效确切,可作为颈椎后纵韧带骨化症的首选术式。     

颈椎后路三种手术方式对改善多节段颈椎病生理曲度及疗效的远期观察

[目的]本研究通过回顾性分析行颈椎后路手术的多节段脊髓型颈椎病合并后纵韧带骨化(ossificationofposteriorlongitudinalligament.OPLL)患者的颈椎曲率变化、JOA评分改善率以及颈肩轴性痛VAS评分改善率,比较颈椎后路三种手术方式对改善颈椎曲度、神经功能及轴性症状的远期影响.[方法]根据手术方式分三组:A组颈椎后路单开门椎管扩大成形术29例,B组颈椎后路全椎板切除术23例,C组颈椎后路全椎板切除侧块螺钉内固定术26例,记录术前、术后的颈椎曲度、JOA评分及轴性症状等.[结果]JOA评分改善率:3组患者术后与术前相比均有统计学意义(P＜0.05).末次随访时c组最高.颈椎曲度改善率:C组最好,A组次之,B组最差.并发症发生情况:在轴性症状上,3组的VAS评分两两比较有统计学意义(P＜0.05),B组最高,A组次之,C组最低.[结论]采用颈椎后路三种手术方式治疗多节段脊髓型颈椎病合并OPLL均能达到良好的疗效.颈椎后路全椎板切除侧块螺钉内固定术可有效改善神经功能,恢复和保持颈椎曲度,降低轴性症状及C5神经根麻痹发生率.     

单节段颈椎后纵韧带骨化症前后路手术的疗效比较

目的比较前路与后路手术治疗颈椎后纵韧带骨化症(ossification of posterior longitudinal ligament,OPLL)的疗效。方法回顾2006年1月～2010年12月,收治的24例单节段颈椎OPLL患者,根据手术入路分为2组,前路手术(A组)10例,行前路骨化节段椎体次全切除、骨化的后纵韧带切除,前路植骨融合内固定;后路手术(B组)14例,行后路减压,以骨化节段椎板为中心,切除3节段全椎板,后路植骨融合,内固定。比较2组患者术前、术后1周、3个月、12个月和24个月的日本骨科学会(Japanese Orthopaedic Association,JOA)评分以及并发症情况。结果所有患者JOA评分均有不同程度的改善,较术前的差异有统计学意义(P<0.05)。但2组患者术后JOA评分差异无统计学意义(P<0.05)。A组术后并发脑脊液漏及脊髓功能下降各1例;B组术后并发C5神经综合征及切口脂肪液化各1例。结论单节段颈椎OPLL前路手术与后路手术的近中期疗效无明显差异。后路手术风险相对较小,前路手术难度较大,并发症较严重。     

颈椎后纵韧带骨化症的手术治疗

[目的]探讨不同手术入路治疗颈椎后纵韧带骨化症的效果.[方法]回顾性分析87例颈椎后纵韧带骨化症患者的临床表现、影像学检查、各种手术途径、术式及其效果.[结果]前路手术35例,其中骨化灶直接切除19例、骨化灶漂浮13例和不用减压的前路椎间融合3例.后路手术21例,其中单开门椎管成形6例,全椎板切除减压15例,前后联合手术31例.患者术前JOA评分平均为8.9(4～17)分.本组患者随访1～10年,平均4.8年,术后JOA评分,前路手术平均14.1分,平均改善率68.3%,后路手术平均11.9分,平均改善率51.2%,前后路手术平均13.4分,平均改善率65.4%.并发节段性神经根麻痹4例;肌肉不全瘫痪者1例;脑脊液漏2例:喉返神经损伤1例.[结论]明确手术指征要综合考虑患者的年龄、病程、骨化程度、椎管狭窄率,以及脊髓功能损害情况,应根据颈椎后纵韧带骨化的具体部位、范围、椎管矢状面狭窄率选择相应的手术入路和术式.应用内固定有利于植骨融合和保持颈椎的稳定.     

超声骨刀与高速磨钻在颈椎后路全椎板切除减压手术应用中的比较研究

目的:比较超声骨刀和高速磨钻在颈椎后纵韧带骨化症伴椎管狭窄行后路全椎板切除减压手术中的安全性与有效性。方法:回顾分析2013年9月~2016年12月确诊为颈椎后纵韧带骨化伴椎管狭窄症行颈椎后路全椎板切除减压结合侧块/椎弓根螺钉内固定的患者53例。其中超声骨刀组(A组)24例,共切除椎板101个节段。高速磨钻组(B组)29例,共切除椎板124个节段。观察记录两组患者术中全椎板切除时间、手术过程中单节段椎板切除平均出血量、围手术期并发症(脊髓损伤、神经根损伤、硬膜囊损伤、脑脊液漏等),JOA评分及改善率。术后评估两组患者神经症状及并发症情况。结果:两组患者的年龄、性别比、术前JOA评分和减压节段数差异均无统计学意义(P0.05)。A组患者平均单个节段全椎板截骨时间为1.7±1.1min(1.4~3.3min),低于B组的2.9±1.8min(1.9~5.6min)(P0.05),手术过程中两组单节段椎板切除平均出血量为52.4±36.5ml(35.1~285.6ml)和60.3±34.2ml(41.1~281.4ml),两组比较无显著性差异(P0.05)。A、B组JOA评分分别由术前9.3±3.1分提高到术后12.7±2.0分和术前9.1±3.4分提高到术后12.9±2.8分,P0.05。两组患者术后JOA评分均明显优于术前(P0.05),但两组JOA改善率(分别为45.6%和51.2%)比较,差异无统计学意义(P0.05)。两组患者均未出现脊髓、神经根及硬膜囊损伤,无截骨操作相关并发症发生。结论:超声骨刀和高速磨钻均能安全有效地完成颈椎OPLL后路全椎板切除减压手术,在减轻术者工作强度、不增加出血及并发症的同时,超声骨刀能有效缩短全椎板切除时间。     

颈椎后纵韧带骨化症后路手术并发C_5神经根麻痹的临床观察

目的探讨颈椎后路单开门椎管扩大成形术与颈椎后路椎板切除减压椎弓根钉内固定术治疗颈椎后纵韧带骨化症并发C_5神经根麻痹的影响因素,并总结预防和治疗经验。方法回顾性分析自2011-06—2014-06诊治的83例颈椎后纵韧带骨化症,43例行颈后路单开门椎管扩大微型钛板成形术(A组),40例行颈后路椎板切除减压椎弓根钉内固定术(B组)。比较2组术前及末次随访时JOA评分,以及C_5神经根麻痹发生率。结果术后1~3 d内共出现8例(9.6%)C_5神经根麻痹,其中A组出现2例(4.7%),B组出现6例(15.0%);A组术后C_5神经根麻痹发生率低于B组,差异有统计学意义(P 0.05)。8例C_5神经根麻痹患者采用甘露醇脱水及地塞米松治疗,进行积极功能锻炼,症状得到缓解;2例遗留肩部疼痛及关节活动受限,在全身麻醉下行肩关节松解术。2组末次随访时JOA评分较术前明显提高,差异有统计学意义(P 0.05)。结论颈椎后路单开门椎管扩大成形术和椎板切除减压椎弓根钉内固定术治疗颈椎后纵韧带骨化症均能获得有效的神经功能恢复,但颈椎后路椎板切除减压椎弓根钉内固定术后并发C_5神经根麻痹的概率更高,因此需在围手术期进行合理预防和治疗以降低术后C_5神经根麻痹的发生率及其严重程度。     

责任节段椎板全切侧块螺钉内固定术治疗伴后纵韧带骨化症的多节段颈椎病疗效分析

[目的]探讨责任节段椎板全切侧块螺钉内固定术治疗伴后纵韧带骨化症的多节段颈椎病的临床疗效.[方法]回顾性分析2007年5月～ 2010年10月手术治疗的多节段颈椎病伴后纵韧带骨化症表现的患者61例,所选多节段病例中(≥3),3个节段50例,4个节段11例.分别采用前后路两种术式,都在显微镜辅助下操作,其中颈后路责任节段椎板全切除侧块螺钉内固定术47例(A组),颈前路椎体次全切钛网植骨融合钛板内固定术14例(B组),分别记录两组手术前后JOA评分及轴性症状VAS评分,加以评定两组术后神经功能改善率(RIS)情况,通过对比分析责任节段椎板全切侧块螺钉内固定术的临床疗效.[结果] 61例患者均获得随访,随访时间在6～38个月,平均16个月.A组的JOA和VAS评分术前分别为(7.2±1.5)、(6.8±2.1)分;术后1周分别为(13.2±2.4)、(2.5±1.4)分;末次随访分别为(13.7±1.8)、(2.3±2.0)分;RIS为(59.92±13.46)％.B组术前JOA和VAS评分分别为(7.5±1.3)、(7.1±2.4)分;术后1周分别为(13.8±2.1)、(2.3±1.5)分;末次随访分别为(14.1±1.6)、(2.2±1.8)分;RIS为(62.28±14.16)％.A组、B组术后1周、末次随访JOA和VAS评分与术前比较均有显著性差异(P＜0.05),两组间的术前JOA、VAS评分及术后RIS无统计学差异(P＞0.05).[结论]颈前、后路治疗伴后纵韧带骨化症的多节段颈椎病均取得良好的手术疗效,少节段局灶性后纵韧带骨化应以前路为主,对于多节段连续性后纵韧带骨化尤其椎管明显狭窄者,后路责任节段椎板全切侧块螺钉内固定术在有效改善神经功能、轴性症状的同时兼顾了良好的脊柱稳定性,是一种相对安全灵活、使用范围较广的术式.     

颈椎不稳在交感型颈椎病发病中的作用

目的：研究交感型颈椎病的病理因素及治疗方法。方法：回顾分析了1988-2000年收治的20例手术治疗的交感型颈椎病患者。根据术前及术后颈椎伸屈侧位X光片判断有无颈椎不稳。结果：20例患者术前均有颈椎不稳,颈椎不稳主要发生在C3-C4和C4-C5,颈椎高位硬膜外封闭对大部分患者有短期效果。每例患者均于不稳节段行颈前路融合术,手术有效率为90％。结论：颈椎不稳是导致交感型颈椎病发病的重要因素;颈椎高位硬膜外封闭可有短期疗效因此具有重要的诊断价值;颈椎前路植骨融合术是治疗交感型颈椎病的有效方法。     

Postoperative instability of cervical OPLL and cervical radiculomyelopathy

The presence of cervical spine instability with respect to preoperative and postoperative changes in angular, horizontal, and rotational displacement of the vertebral body were studied. With the anterior approach, the instability in the remaining unfused segments, and their relation to the kyphotic or lordotic fused segment were studied. With the posterior approach, postoperative ROM (range of motion) could be better maintained, and horizontal displacement was improved in more cases by laminoplasty compared with laminectomy. With the anterior approach, the compensatory function for the loss of motion of the segments resulting from fusion was most remarkable at the levels of C2-3 and C6-7. In the alignment of the anterior fused segments, it appears important that the physiologic lordotic position be maintained.     

Anterior cervical foramenotomy for cervical radiculopathy

Anterior cervical discectomy (ACD) is standard practice for cervical radiculopathy. Irrespective of the precise method used, it involves more or less complete disc removal with resultant anatomical and biomechanical derangements, and frequently the insertion of a bone or prosthetic graft. Anterior cervical foramenotomy is an alternative procedure that allows effective anterior decompression of the nerve root and lateral spinal cord, whilst conserving the native disc, preserving normal anatomy and movement, and protecting against later degeneration at adjacent spaces as far as possible. The aim of the study was to determine the safety and efficacy of anterior cervical foramenotomy in the treatment of cervical radiculopathy and took the form of a prospective study of 21 cases under the care of a single surgeon. All patients had a single level or two level anterior cervical foramenotomy. All had pre- and postoperative visual analogue scores for arm and neck pain, arm strength, sensation and overall use. A comparison between patients' perceptions and surgeon's observations was also made. Patients were followed up for between 10 and 36 months. Sixty-eight per cent completed full pre- and postoperative assessments. Twenty-eight per cent of the responders had complete arm pain resolution. There were statistically significant reductions in arm and neck pain, and overall disability. The surgeon's impression of improvement paralleled that of the patients. There was one complication with discitis. Anterior cervical foramenotomy is a safe and effective treatment for cervical radiculopathy caused by posterolateral cervical disc prolapse or uncovertebral osteophyte, and might also reduce adjacent segment degeneration.     

Percutaneous cervical nucleoplasty and percutaneous cervical discectomy treatments of the contained cervical disc herniation

Background  

There were no studies in literature to compare the clinical outcomes of percutaneous nucleoplasty (PCN) and percutaneous cervical discectomy (PCD) in contained cervical disc herniation.     

颈横动脉颈段皮支皮瓣修复颈部瘢痕挛缩

目的 观察颈横动脉颈段皮支皮瓣修复颈部瘢痕挛缩的临床效果.方法 笔者单位1988-2011年收治颈前区烧伤后瘢痕挛缩患者66例.采用颈横动脉颈段皮支皮瓣修复患者颈部瘢痕,包括岛状皮瓣55例(其中9例行预扩张)、非岛状皮瓣11例(其中1例行预扩张).术中先切除、松解患者颈部瘢痕,在锁骨上、下及前胸区设计颈横动脉颈段皮支皮瓣,其轴心血管为颈横动脉在胸锁乳突肌、肩胛舌骨肌交界处穿出的皮动脉.皮瓣后界达斜方肌前缘,外侧界达三角肌中段,内侧界达胸骨中线,下界达乳头下3.0 ～4.0 cm处.术中先切开皮瓣外、下、内缘,锐性分离达锁骨平面后改为钝性剥离,分离到蒂部后,分离深度以皮瓣旋转后可无张力覆盖创面为度.其中预扩张的皮瓣供区直接拉拢缝合,非预扩张皮瓣供区植皮封闭.结果 本组患者中64例术后皮瓣成活良好;2例术后皮瓣下血肿致尖端部分坏死,经补充植皮后治愈;供区均愈合.所有皮瓣色泽、质地与周围组织匹配良好;皮瓣感觉功能术后初期恢复为胸部感觉,6个月后完全恢复为颈部感觉.结论 颈横动脉颈段皮支皮瓣血供恒定,解剖操作相对简便,皮瓣色泽、质地与颈部相近,是修复颈部严重瘢痕挛缩的良好选择.     

经皮髓核成形术与椎间盘切除术治疗退变性颈椎间盘突出症

目的比较经皮髓核成形术与经皮椎间盘切除术治疗退变性颈椎间盘突出症的临床疗效及对颈椎稳定性的影响。方法2002年7月至2004年12月共收治退变性颈椎间盘突出症患者80例,行经皮髓核成形术42例(PCN组),经皮椎间盘切除术38例(PCD组)。回顾性分析两组的临床资料,比较两组在手术时间、临床效果及颈椎稳定性等的差异。结果所有病例随访6~26个月,PCN组平均(12±5)个月;PCD组平均(12±4)个月。两组手术均获成功。两组手术时间有显著差异(t=-21·70,P=0·000);两组手术临床效果(JOA评分)经自身配对t检验显示均有显著性差异(PCN:t=14·05,P=0·000;PCD:t=-14·79,P=0·000),即两组均有效;两组手术临床效果(Williams评分)经Kruskal-Wallis检验无显著差异(z=-0·377,P=0·706,>0·05),即两组临床效果相似。两组手术后均无颈椎不稳病例发生,颈椎稳定性手术前后均无显著差异(P>0·05)。结论经皮髓核成形术与经皮椎间盘切除术治疗颈椎间盘突出症的临床疗效优良,对颈椎稳定性影响小,不会造成颈椎失稳的发生。     

颈椎不稳致交感型颈椎病的诊断和治疗

目的 探讨交感型颈型病的发病机制及有效的治疗方法。方法 回顾了1989-1998年应用颈前路间盘切除加植骨融合术治疗的交感型颈椎病患者18例,分析了患者产及术后颈椎伸、屈侧位X光片。结果 18例患者术前均有颈椎不稳,不稳定节段为1个者6例,2个者9例,3个者3例;颈椎不稳主要发生于C3-C4和C4-C5,偶见于C5-C6和C6-C7。14例患者术前行颈椎高位硬膜外封闭,11例有效;于不稳定节段行颈前路间盘切除加植骨融合术,18例均获随访,平均随访时间为1年9个月,术后有效率为88.9%,结论 颈椎不稳定是交感型颈椎病发病的重要因素。颈椎高位硬膜外封闭具有重要的诊断价值。颈前路间盘切除加植骨融合术是治疗交感型颈椎病的有效方法。     

颈椎自锁PEEK椎间融合器在颈椎病治疗中的应用

目的评价应用颈椎自锁PEEK椎间融合器前路减压治疗颈椎病的疗效。方法应用颈椎自锁PEEK椎间融合器治疗颈椎病患者18例,观察椎间融合器的稳定性和融合情况,采用Borden法测量椎间隙高度、颈椎曲度,对术前和术后JOA评分、椎间隙高度、颈椎曲度等指标进行统计学分析。结果 18例患者均获随访,时间6～42个月,未见严重并发症。术后6个月提示椎间骨性融合。椎间高度:术前为(3.26±0.68)mm,术后1周为(6.03±0.89)mm(P<0.01);术后6个月为(5.89±0.78)mm,与术后1周比较变化不大(P>0.05)。颈椎生理弧度:术前为(2.55±0.48)mm,术后1周为(3.24±0.67)mm(P>0.05);术后6个月为(8.14±1.17)mm,与术后1周比较明显改善(P<0.01)。末次随访根据JOA评分法进行疗效评价:优4例,良9例,可3例,差2例。结论颈椎自锁PEEK椎间融合器可以有效恢复颈椎生理曲度及椎间隙高度,可以获得满意的融合率,改善颈脊髓功能。     

Posterior cervical laminoplasty formultilevel cervical spine stenosis

Cervical laminoplasty for treating multilevel spinal stenosis appears to be a good surgical alternative to the more traditional laminectomy or anterior decompression and fusion. This procedure avoids the morbidity associated with extensive anterior procedures and also appears not to be associated with late kyphosis, which can be seen in patients after a laminectomy. This review outlines the rationale, indications, contraindications, and early clinical results for patients undergoing a posterior laminoplasty.     

Comparison of cervical kinematics between patients with cervical artificial disc replacement and anterior cervical discectomy and fusion for cervical disc herniation

Background contextAlthough anterior cervical discectomy and fusion (ACDF) is an effective treatment option for patients with cervical disc herniation, it limits cervical range of motion, which sometimes causes discomfort and leads to biomechanical stress at neighboring segments. In contrast, cervical artificial disc replacement (ADR) is supposed to preserve normal cervical range of motion than ACDF. A biomechanical measurement is necessary to identify the advantages and clinical implications of ADR. However, literature is scarce about this topic and in those available studies, authors used the static radiological method, which cannot identify three-dimensional motion and coupled movement during motion of one axis.PurposeThe purpose of this study was to compare the clinical parameters and cervical motion by three-dimensional motion analysis between ACDF and ADR and to investigate the ability of ADR to maintain cervical kinematics.Study designThis was a prospective case control study.Patient samplePatients who underwent ADR or ACDF for the treatment of single-level cervical disc herniation.Outcome measuresVisual analog scale (VAS), Korean version of Neck Disability Index (NDI, %), and three-dimensional motion analysis were used.MethodsThe patients were evaluated by VAS and the Korean version of the NDI (%) to assess pain degree and functional status. Cervical motions were assessed by three-dimensional motion analysis in terms of sagittal, coronal, and horizontal planes. Markers of 2.5 cm in diameter were attached at frontal polar (Fpz), center (Cz), and occipital (Oz) of 10–20 system of electroencephalography, C7 spinous process, and both acromions. These evaluations were performed preoperatively and 1 month and 6 months after surgery.ResultsThe ACDF and ADR groups revealed no significant difference in VAS, NDI (%), and cervical range of motion preoperatively. After surgery, both groups showed no significant difference in VAS and NDI (%). In motion analysis, significantly more range of motion was retained in flexion and extension in the ADR group than the ACDF group at 1 month and 6 months. There was no significant difference in lateral tilt and rotation angle. In terms of coupled motion, ADR group exhibited significantly more preserved sagittal plane motion during right and left rotation and also showed significantly more preserved right lateral bending angle during right rotation than ACDF group at 1 month and 6 months. There was no significant difference in other coupled motions.ConclusionThree-dimensional motion analysis could provide useful information in an objective and quantitative way about cervical motion after surgery. In addition, it allowed us to measure not only main motion but also coupled motion in three planes. ADR demonstrated better retained cervical motion mainly in sagittal plane (flexion and extension) and better preserved coupled sagittal and coronal motion during transverse plane motion than ACDF. ADR had the advantage in that it had the ability to preserve more cervical motions after surgery than ACDF.