Ikenaga Minoru, Shikata Jitsuhiko, Tanaka Chiaki
Department of Orthopedic Surgery, Kyoto City Hospital, Kyoto-shi, Kyoto, Japan.
Spine (Phila Pa 1976). 2006 Jun 15;31(14):1568-74; discussion 1575. doi: 10.1097/01.brs.0000221985.37468.0f.
Retrospective long-term outcome analysis over more than 10 years.
To assess the long-term results of anterior corpectomy and fibular strut grafting over > or =4 disc levels for cervical myelopathy, and identify factors affecting the late deterioration in clinical outcome.
Few studies have shown long-term results after anterior corpectomy and strut grafting. There is little detailed information about the long-term effects of multilevel anterior corpectomy and fusion for cervical myelopathy.
A total of 31 cases were available for the 10-year follow-up after surgery (86% follow-up rate). Clinical results and radiographic measurements were obtained before surgery, 3 months after surgery, and at follow-up.
There were 3 patients who had deterioration of the Japanese Orthopedic Association score of 1 point because of increasing hand numbness; 1 patient had adjacent disc degeneration, and 1 had pseudarthrosis without additional stenosis on magnetic resonance imaging. Adjacent disc degeneration did not affect the clinical results (P = 0.76).
The long-term follow-up showed stable clinical results for more than 10 years, which depended on the thorough removal of the possible causes of the myelopathy, such as ossification of the posterior longitudinal ligament or a degenerated disc. Adjacent disc degeneration has minimal effects on the long-term clinical results after anterior long fusion.
超过10年的回顾性长期疗效分析。
评估前路椎体次全切除及腓骨支撑植骨治疗4个及以上节段颈椎病的长期疗效，并确定影响临床疗效后期恶化的因素。
很少有研究报道前路椎体次全切除及支撑植骨后的长期疗效。关于多节段前路椎体次全切除及融合治疗颈椎病的长期影响，详细信息较少。
共有31例患者术后接受了10年随访（随访率86%）。在术前、术后3个月及随访时获取临床结果和影像学测量数据。
3例患者因手部麻木加重，日本矫形外科学会评分下降1分；1例出现相邻节段椎间盘退变，1例出现假关节形成，磁共振成像显示无额外狭窄。相邻节段椎间盘退变未影响临床结果（P = 0.76）。
长期随访显示，超过10年的临床结果稳定，这取决于彻底去除脊髓病的可能病因，如后纵韧带骨化或退变椎间盘。相邻节段椎间盘退变对前路长节段融合术后的长期临床结果影响极小。
