Epstein N E
The Albert Einstein College of Medicine, Bronx, New York, USA.
Surg Neurol. 2001 Oct;56(4):256-8. doi: 10.1016/s0090-3019(01)00579-1.
Posterior cervical unilateral diskectomy and decompression for stenosis with instability may be successfully stabilized with contralateral diskectomy and fusion.
A 49-year-old male with a left-sided C8 radiculopathy had dynamic X-ray, MR, and CT studies that documented an old anterior diskectomy and fusion at the C5-C6 level, and a new left-sided foraminal disc herniation at the C7-T1 level with instability, accompanied by C6-T1 spondylostenosis. Following left-sided C6-T1 laminectomies with excision of C7-T1 disc, a contralateral right-sided C5-T2 fusion was performed with fibula strut allograft wired to the spinous processes using titanium cable and iliac crest autograft.
X-ray and 2D CT studies performed 3 and 6 months postoperatively confirmed adequate unilateral decompression of stenosis with disc removal and contralateral fusion. Within three weeks of surgery, the patient had no residual neurological deficit. Three years later, he remained intact, and X-ray studies continued to demonstrate spinal stability.
A unilateral C7-T1 disc herniation with instability accompanied by C6-T1 spondylostenosis were successfully managed with unilateral decompression and disc excision followed by contralateral fusion.
后路颈椎单侧椎间盘切除术及针对伴有不稳的狭窄症进行减压时，可通过对侧椎间盘切除术及融合术成功实现稳定。
一名49岁男性，患有左侧C8神经根病，接受了动态X线、磁共振成像（MR）及计算机断层扫描（CT）检查，结果显示C5-C6水平有陈旧性前路椎间盘切除术及融合术，C7-T1水平有新的左侧椎间孔椎间盘突出伴不稳，并伴有C6-T1椎管狭窄。在进行左侧C6-T1椎板切除术并切除C7-T1椎间盘后，采用腓骨支撑异体骨，通过钛缆固定于棘突，并取髂嵴自体骨，进行了对侧右侧C5-T2融合术。
术后3个月和6个月进行的X线及二维CT检查证实，通过椎间盘切除及对侧融合实现了对狭窄症的充分单侧减压。术后三周内，患者无残留神经功能缺损。三年后，他情况良好，X线检查持续显示脊柱稳定。
对于伴有不稳的单侧C7-T1椎间盘突出并伴有C6-T1椎管狭窄，通过单侧减压及椎间盘切除，随后进行对侧融合，成功实现了治疗。
