van Geest Sarita, de Vormer Anouk M J, Arts Mark P, Peul Wilco C, Vleggeert-Lankamp Carmen L A
Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands,
Eur Spine J. 2015 Apr;24 Suppl 2:229-35. doi: 10.1007/s00586-013-3089-6. Epub 2013 Nov 13.
To evaluate long-term clinical and radiological results of cervical laminectomy without adjuvant-instrumented fusion for degenerative spinal cord compression.
A retrospective follow-up study of patients in which clinical data (n = 207), questionnaires (n = 96) and fluoroscopy (n = 77) were reviewed.
Postoperative perceived recovery was reported by 76 and 63 % of patients at 3 months and 9 years, respectively. Functional status remained unchanged. The incidence of kyphosis and segmental instability was 15 and 18 %, respectively, and occurred almost exclusively if preoperative lordosis was <20°. Neither kyphosis nor segmental instability correlated to perceived recovery and no predisposing variables were identified.
Cervical laminectomy without adjuvant-instrumented fusion should be considered as a treatment for compressive degenerative cervical myelopathy in patients with a lordotic cervical spine without congenital deformities. Additional reconstructive correction of the cervical spine is only proven appropriate in selected cases.
评估无辅助器械融合的颈椎椎板切除术治疗退行性脊髓压迫症的长期临床和影像学结果。
对患者进行回顾性随访研究,回顾临床资料(n = 207)、问卷调查(n = 96)和透视检查(n = 77)。
分别有76%和63%的患者在术后3个月和9年报告感觉恢复。功能状态保持不变。后凸畸形和节段性不稳定的发生率分别为15%和18%,几乎仅在术前前凸小于20°时出现。后凸畸形和节段性不稳定均与感觉恢复无关,且未发现诱发变量。
对于无先天性畸形的前凸颈椎患者,无辅助器械融合的颈椎椎板切除术应被视为治疗压迫性退行性颈椎病的一种方法。仅在特定病例中证明额外的颈椎重建矫正才是合适的。