Haden N, Latimer M, Seeley H M, Laing R J
Academic Department of Neurosurgery, University of Cambridge, Cambridge, UK.
Br J Neurosurg. 2005 Dec;19(6):469-74. doi: 10.1080/02688690500495109.
Most surgeons undertaking anterior cervical discectomy (ACD) introduce a bone graft or cage into the disc space when the decompression is complete. This is done to prevent segmental collapse, preserve cervical spine alignment and to promote fusion. We have conducted a prospective observational cohort study to investigate the relationship between loss of disc height, cervical spine alignment and clinical outcome in 140 patients undergoing ACD without inter-body graft or cage. At a minimum of 12 months after operation changes in disc space height and cervical spine alignment were correlated with clinical outcome measured by SF36, Neck Disability Index, and visual analogue neck and arm pain scores. There was no relationship between loss of disc height and outcome. Loss of the overall cervical lordosis was present in 71 patients and segmental kyphosis was found in 69. Analysis of clinical outcome showed no significant differences between patients with preserved and abnormal cervical alignment. Neither loss of disc height nor disturbance of cervical alignment compromised clinical outcome in the first year following ACD.
大多数实施颈椎前路椎间盘切除术（ACD）的外科医生在减压完成后会在椎间盘间隙植入骨移植体或椎间融合器。这样做是为了防止节段性塌陷，保持颈椎排列，并促进融合。我们进行了一项前瞻性观察队列研究，以调查140例行ACD但未进行椎间植骨或植入椎间融合器的患者中椎间盘高度丢失、颈椎排列与临床结局之间的关系。术后至少12个月时，椎间盘间隙高度和颈椎排列的变化与通过SF36、颈部功能障碍指数以及视觉模拟颈部和手臂疼痛评分所测量的临床结局相关。椎间盘高度丢失与结局之间没有关系。71例患者存在整体颈椎前凸丢失，69例发现节段性后凸。临床结局分析显示，颈椎排列正常和异常的患者之间没有显著差异。在ACD后的第一年，椎间盘高度丢失和颈椎排列紊乱均未损害临床结局。
