Nara Medical University, 840 Kashihara, Nara, 634-8522, Japan.
Eur Spine J. 2010 May;19(5):720-5. doi: 10.1007/s00586-010-1338-5. Epub 2010 Feb 27.
The objective of the study was to investigate the comorbidity of degenerative spondylolisthesis (DS), in elderly cervical spondylotic myelopathy (CSM) patients in our hospital, and the correlation between surgical results and preoperative DS. There are few studies on the outcome of laminoplasty for CSM with DS. A total of 49 elderly patients (>65 years old) who eventually had surgical treatment for CSM were evaluated. A slippage displacement of more than 2.5 mm at least at one level was classified to have a positive DS on flexion/extension radiographs (DS group). A slippage displacement less than 1.0 mm was considered a negative DS (non-DS group). Seventeen patients who had slippage of 1.0-2.5 mm were excluded from the study. The DS group (n = 15) included cases with DS at preoperation, while the remaining cases (n = 17) belonged to the non-DS group. The flexion/extension radiographs of the two groups were compared for range of motion and clinical results at 3 years after the operation. Of all elderly patients, 30.6% had DS. There was no significant difference between the two groups based on the clinical results. The range of motion of all cervical spines (DS group and non-DS group) was significantly limited. However, there was no significant difference between the two groups. New postoperative DS appeared in four patients, of which two were from the DS group and two from the non-DS group. These data suggest that degenerative spondylolisthesis does not influence surgical results in elderly cervical spondylotic myelopathy patients.
本研究旨在探讨我院老年型颈椎病伴退行性脊椎滑脱症(DS)患者的合并症,以及术前 DS 与手术结果的相关性。对于合并 DS 的脊髓型颈椎病行椎板成形术的疗效,目前研究较少。共评估了 49 例最终接受脊髓型颈椎病手术治疗的老年患者(>65 岁)。颈椎屈伸位 X 线片上至少一个节段滑脱移位>2.5mm 定义为阳性 DS(DS 组),<1.0mm 定义为阴性 DS(非 DS 组)。17 例滑脱 1.0-2.5mm 的患者被排除在研究之外。DS 组(n=15)为术前存在 DS 的病例,其余病例(n=17)属于非 DS 组。比较两组患者术后 3 年的屈伸位 X 线片活动度和临床结果。所有老年患者中,30.6%存在 DS。两组间的临床结果无显著差异。所有颈椎(DS 组和非 DS 组)的活动度均明显受限,但两组间无显著差异。术后新发 DS 4 例,其中 2 例来自 DS 组,2 例来自非 DS 组。这些数据表明,退行性脊椎滑脱症并不影响老年型脊髓型颈椎病患者的手术结果。
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