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多节段颈椎间盘退变疾病的杂交手术：文献综述与临床结果

Hybrid surgery of multilevel cervical degenerative disc disease : review of literature and clinical results.

作者信息

Lee Sang-Bok, Cho Kyoung-Suok, Kim Jong-Youn, Yoo Do-Sung, Lee Tae-Gyu, Huh Pil-Woo

机构信息

Department of Neurosurgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea School of Medicine, Uijeongbu, Korea.

出版信息

J Korean Neurosurg Soc. 2012 Nov;52(5):452-8. doi: 10.3340/jkns.2012.52.5.452. Epub 2012 Nov 30.

DOI:10.3340/jkns.2012.52.5.452
PMID:23323165
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3539079/
Abstract

OBJECTIVE

In the present study, we evaluated the effect, safety and radiological outcomes of cervical hybrid surgery (cervical disc prosthesis replacement at one level, and interbody fusion at the other level) on the multilevel cervical degenerative disc disease (DDD).

METHODS

Fifty-one patients (mean age 46.7 years) with symptomatic multilevel cervical spondylosis were treated using hybrid surgery (HS). Clinical [neck disability index (NDI) and Visual Analogue Scale (VAS) score] and radiologic outcomes [range of motion (ROM) for cervical spine, adjacent segment and arthroplasty level] were evaluated at routine postoperative intervals of 1, 6, 12, 24 months. Review of other similar studies that examined the HS in multilevel cervical DDD was performed.

RESULTS

Out of 51 patients, 41 patients received 2 level hybrid surgery and 10 patients received 3 level hybrid surgery. The NDI and VAS score were significantly decreased during the follow up periods (p<0.05). The cervical ROM was recovered at 6 and 12 month postoperatively and the mean ROM of inferior adjacent segment was significantly larger than that of superior adjacent segments after surgery. The ROM of the arthoplasty level was preserved well during the follow up periods. No surgical and device related complications were observed.

CONCLUSION

Hybrid surgery is a safe and effective alternative to fusion for the management of multilevel cervical spondylosis.

摘要

目的

在本研究中，我们评估了颈椎混合手术（一个节段进行颈椎间盘假体置换，另一个节段进行椎间融合）治疗多节段颈椎退行性椎间盘疾病（DDD）的疗效、安全性和影像学结果。

方法

采用混合手术（HS）治疗51例有症状的多节段颈椎病患者（平均年龄46.7岁）。在术后1、6、12、24个月的常规随访间隔期评估临床指标[颈部功能障碍指数（NDI）和视觉模拟评分（VAS）]以及影像学结果[颈椎、相邻节段和人工关节置换节段的活动度（ROM）]。对其他研究多节段颈椎DDD的混合手术的类似研究进行了综述。

结果

51例患者中，41例接受了两节段混合手术，10例接受了三节段混合手术。随访期间NDI和VAS评分显著降低（p<0.05）。术后6个月和12个月颈椎活动度恢复，术后下相邻节段的平均活动度明显大于上相邻节段。人工关节置换节段的活动度在随访期间保持良好。未观察到与手术和器械相关的并发症。

结论

对于多节段颈椎病的治疗，混合手术是一种安全有效的融合替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c53/3539079/97179c2ad897/jkns-52-452-g007.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c53/3539079/7ac6d64ef789/jkns-52-452-g001.jpg
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