Abstract:Abstract: [Objective] This study aimed to investigate the clinical efficacy and outcome of microscope-assisted anterior cervical discectomy and fusion (ACDF) with traditional ACDF of cervical spondylotic myelopathy.Methods: A retrospective was conducted on 65 patients who underwent surgical treatment for cervical spondylotic myelopathy in our hospital from June 2016 to November 2018. According to the consequences of preoperative doctor-patient communication, 30 patients received microscope cohort, while the remaining patients underwent non-microscope cohort. The perioperative, follow up and radiographic documents were compared between the two groups. The microscopy group had significantly less intraoperative blood loss and duration of surgery than the traditional group [(104.17±20.64) ml versus (129.77±47.96)ml,(93.53±13.16)min versus(101.37±15.89)min,P<0.05], The JOA scores increased significantly(P<0.05), while the NDI scores and VAS scores decreased significantly in both groups over time (P<0.05) .There were no significant differences in JOA and NDI、VAS scores between the two groups before operation (P>0.05). The microscopy group proved significantly superior to the traditional group regarding the JOA scores six month and follow up after operation [(16.83±2.17)versus(15.74±1.60),(28.90±1.97)versus(27.34±1.67),P<0.05]. regardless of that the differences became not statistically significant at 6 months and follow up after surgery between the two groups in NDI、VAS scores (P>0.05) [Results] Patients in both groups were successfully operated. In terms of imaging evaluation, the C2-7 Cobb angle, the height of the involved disc and spinal canal area of the responsible segment significantly improved in both groups at the latest follow-up compared with those preoperatively (P<0.05). At any corresponding time point, there was no statistically significant difference in the above-mentioned items measured radiographically between the two groups(P>0.05) [Conclusion] Compared with traditional surgery, ACDF under microscope has the advantages of less bleeding, shorter operation time, less pain, obvious improvement of neurological function, and good recovery of cervical function