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多节段脊髓型颈椎病伴后纵韧带骨化的“Skip”椎体切除术。

"Skip" corpectomy in the treatment of multilevel cervical spondylotic myelopathy and ossified posterior longitudinal ligament.

机构信息

Department of Neurosurgery, Lütfi Kirdar Kartal Teaching and Research Hospital, Istanbul, Turkey.

出版信息

J Neurosurg Spine. 2010 Jan;12(1):33-8. doi: 10.3171/2009.7.SPINE08965.


DOI:10.3171/2009.7.SPINE08965
PMID:20043761
Abstract

OBJECT: The authors reviewed the results of "skip" corpectomy in 29 patients with multilevel cervical spondylotic myelopathy (CSM) and ossified posterior longitudinal ligament (OPLL). METHODS: The skip corpectomy technique, which is characterized by C-4 and C-6 corpectomy, C-5 osteophytectomy, and C-5 vertebral body preservation, was used for decompression in patients with multilevel CSM and OPLL. All patients underwent spinal fixation using C4-5 and C5-6 grafts, and anterior cervical plates were fixated at C-3, C-5, and C-7. RESULTS: The mean preoperative Japanese Orthopaedic Association score increased from 13.44 +/- 2.81 to 16.16 +/- 2.19 after surgery (p < 0.05). The cervical lordosis improved from 1.16 +/- 11.74 degrees to 14.36 +/- 7.85 degrees after surgery (p < 0.05). The complications included temporary hoarseness in 3 cases, dysphagia in 1 case, C-5 nerve palsy in 1 case, and C-7 screw pullout in 1 case. The mean follow-up was 23.2 months. The final plain radiographs showed improved cervical lordosis and fusion in all cases. CONCLUSIONS: The authors conclude that the preservation of the C-5 vertebral body provided an additional screw purchase and strengthened the construct. The results of the current study demonstrated effectiveness and safety of the skip corpectomy in patients with multilevel CSM and OPLL.

摘要

目的:作者回顾了 29 例多节段颈椎病伴后纵韧带骨化(OPLL)患者行跳跃式椎体切除术的结果。

方法:跳跃式椎体切除术技术的特点是 C4 和 C6 椎体切除术、C5 骨赘切除术和 C5 椎体保留,用于多节段颈椎病伴 OPLL 患者的减压。所有患者均采用 C4-5 和 C5-6 移植物进行脊柱固定,并在 C3、C5 和 C7 固定前路颈椎板。

结果:术前日本矫形协会评分平均从 13.44 +/- 2.81 增加到术后 16.16 +/- 2.19(p < 0.05)。颈椎前凸角从术前的 1.16 +/- 11.74 度改善到术后的 14.36 +/- 7.85 度(p < 0.05)。并发症包括 3 例暂时性声音嘶哑、1 例吞咽困难、1 例 C5 神经根麻痹和 1 例 C7 螺钉拔出。平均随访 23.2 个月。最终的平片显示所有病例颈椎前凸角改善,融合良好。

结论:作者认为 C5 椎体的保留提供了额外的螺钉固定点,并增强了结构的稳定性。本研究结果表明,跳跃式椎体切除术治疗多节段颈椎病伴 OPLL 是有效且安全的。

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