Kotil Kadir, Sengoz Ahmet
Istanbul Educational and Research Hospital, Department of Neurosurgery, Istanbul, Turkey.
Turk Neurosurg. 2011 Jan;21(1):15-21.
Cervical disc herniation at C2-C3 level is an uncommon condition. In this paper, the management C2-C3 disc herniation and long-term follow-up data of 5 cases is reported.
1100 patients who have been operated in our department for cervical disc herniation between 2000 and 2009 were studied retrospectively. A total of 5 patients were found to have been operated for C2-C3 herniation in that period . The preferred procedure was anterior cervical discectomy with fusion via retropharyngeal approach.
The incidence of C2-C3 disc herniations was 0.45%. The mean patient age was 63 years (41- 82 years). Upper extremity paresis was the predominant neurological sign. Magnetic resonance images (MRI) revealed central, large and hard disc herniations in 4 cases and accompanying cord signal changes in 4 cases. Successful anterior decompresion was performed in 5 patients. Correct fusion was achieved in 4 patients, and one patient died of an operation unrelated cause early in the follow-up period.
C2-C3 disc herniation is rare but may result with severe myelopathy. This kind of herniations tend to be central and large. The present study demonstrates that diagnosis and adequate anterior decompression in C2-C3 disc herniations may provide an excellent outcome.
C2-C3节段颈椎间盘突出症较为罕见。本文报告了5例C2-C3节段椎间盘突出症的治疗及长期随访数据。
回顾性研究2000年至2009年间在我科接受颈椎间盘突出症手术的1100例患者。在此期间,共发现5例患者接受了C2-C3节段椎间盘突出症手术。首选手术方式为经咽后入路颈椎前路椎间盘切除融合术。
C2-C3节段椎间盘突出症的发生率为0.45%。患者平均年龄为63岁(41-82岁)。上肢无力是主要的神经体征。磁共振成像(MRI)显示4例为中央型、巨大且硬的椎间盘突出,4例伴有脊髓信号改变。5例患者均成功进行了前路减压。4例患者实现了正确融合,1例患者在随访早期死于与手术无关的原因。
C2-C3节段椎间盘突出症罕见,但可能导致严重的脊髓病。此类突出往往为中央型且巨大。本研究表明,C2-C3节段椎间盘突出症的诊断及充分的前路减压可能带来良好的治疗效果。