Rocchi Giovanni, Caroli Emanuela, Salvati Maurizio, Delfini Roberto
Department of Neurological Sciences, Neurosurgery, University of Rome La Sapienza, Rome, Italy.
Spine (Phila Pa 1976). 2005 Sep 1;30(17):1963-9. doi: 10.1097/01.brs.0000176327.04725.1b.
The authors provide their results in performing multilevel oblique corpectomy for degenerative spondylotic myelopathy in 48 patients.
To demonstrate the efficacy and safety of the multilevel oblique corpectomy when applied in selected cases.
The technique of multilevel oblique corporectomies for treatment of cervical spondylogenetic myeloradiculopathies allows anterolateral access to the cervical spine so that the spinal canal and conjugate foramen can be widened at more than one level, without the need for vertebral stabilization.
During a 7-year period, multilevel oblique corpectomy was performed in 48 consecutive patients for degenerative spondylotic myelopathy. The outcomes were analyzed according to the Japanese Orthopaedic Association classification modified to Western customs, and according to Nurick's scale 1 month, 1 year, and 2 years after surgery. Spinal stability was evaluated in all patients by plain radiograph films of the cervical spine, lateral views in flexion and extension, on discharge, 1 month and 1 year after operation.
Significant clinical improvement occurred in 29 patients with a complete functional recovery in 22; moderate improvement was achieved in 12 patients; neurological status remained stable in 5, and it worsened in 2. All patients showed spinal stability.
Multilevel oblique corpectomy was found to be a safe technique that guarantees good results in terms of both regression of clinical symptoms and long-term spinal stability.
作者报告了对48例退行性颈椎病脊髓病患者施行多节段斜行椎体次全切除术的结果。
证明多节段斜行椎体次全切除术在特定病例中的有效性和安全性。
多节段斜行椎体次全切除术治疗颈椎退变性脊髓神经根病的技术可经颈前外侧入路显露颈椎,从而在多个节段扩大椎管和椎间孔,无需椎体稳定术。
在7年期间,对48例连续性退行性颈椎病脊髓病患者施行多节段斜行椎体次全切除术。根据参照西方习惯修改后的日本矫形外科学会分类法以及术后1个月、1年和2年的Nurick分级对结果进行分析。通过颈椎正位X线片、屈伸侧位片在出院时、术后1个月和1年对所有患者的脊柱稳定性进行评估。
29例患者临床有显著改善,22例功能完全恢复;12例患者中度改善;5例神经状态保持稳定,2例恶化。所有患者均显示脊柱稳定。
多节段斜行椎体次全切除术是一种安全的技术,在临床症状消退和长期脊柱稳定性方面均能保证良好效果。