Department of Orthopaedic Surgery, University of Rochester, Rochester, New York, United States.
Center for Cervical Spine, Washington University Orthopedics, Washington University in St. Louis, Saint Louis, Missouri, United States.
Global Spine J. 2016 Feb;6(1):7-13. doi: 10.1055/s-0035-1554776. Epub 2015 Jun 5.
Study Design Retrospective study. Objective Cervical scoliosis is a rare condition that can arise from various etiologies. Few reports on the surgical management of cervical scoliosis exist. Our objective was to evaluate clinical and radiographic outcomes following surgical management of cervical scoliosis. Methods We evaluated our cervical spine surgical database for patients with cervical scoliosis (Cobb angle > 10 degrees) from 2005 to 2010. Demographic data including age, gender, diagnoses, and primary versus revision surgery was collected. Surgical data including procedure (anterior versus posterior), estimated blood loss (EBL), length of surgery, length of hospitalization, and complications was recorded. Preoperative and postoperative Cobb angle measurements and Neck Disability Index (NDI) scores were recorded. Results Cervical scoliosis was identified in 18 patients. We excluded 5, leaving 5 men and 8 women with an average age of 50.7 (median 52, range 25 to 65). The average follow-up was 40 months (median 36.5, range 5 to 87). An anterior-only approach was used in 6 cases (average 4 levels fused), 5 cases were posterior-only approach (average 8.7 levels fused), and 2 cases were combined anterior-posterior approach. The EBL was an average of 286 mL (median 150, range 50 to 900), the average surgical time was 266 minutes (median 239, range 136 to 508), and the average hospital stay was 2.7 days (median 2, range 1 to 7). Complications occurred in 7 patients, and 2 developed adjacent segment pathology. The average coronal Cobb angle preoperatively was 35.1 degrees (median 31, range 13 to 63) and corrected was 15.7 degrees (median 10.5, range 2 to 59) postoperatively (p < 0.005). The average NDI preoperatively was 24.9 (median 26, range 6 to 37) and was reduced to 17.8 (median 18, range 7 to 30) postoperatively (p < 0.02). Conclusion Surgical management of cervical scoliosis can result in deformity correction and improvement in patient outcomes. Higher rates of complications may be encountered.
回顾性研究。目的:颈椎侧凸是一种罕见的疾病,可能由多种病因引起。有关颈椎侧凸手术治疗的报告很少。我们的目的是评估颈椎侧凸手术后的临床和影像学结果。方法:我们对 2005 年至 2010 年颈椎侧凸(Cobb 角> 10 度)患者的颈椎脊柱手术数据库进行了评估。收集了人口统计学数据,包括年龄、性别、诊断以及初次手术与翻修手术。记录了手术数据,包括前路与后路、估计失血量(EBL)、手术时间、住院时间和并发症。记录了术前和术后 Cobb 角测量值和颈椎残障指数(NDI)评分。结果:在 18 例患者中发现了颈椎侧凸。我们排除了 5 例,留下了 5 例男性和 8 例女性,平均年龄为 50.7 岁(中位数为 52 岁,范围为 25 至 65 岁)。平均随访时间为 40 个月(中位数 36.5 个月,范围为 5 至 87 个月)。前路单一入路 6 例(平均融合 4 个节段),后路单一入路 5 例(平均融合 8.7 个节段),前路-后路联合入路 2 例。EBL 平均为 286 mL(中位数为 150 mL,范围为 50 至 900 mL),平均手术时间为 266 分钟(中位数为 239 分钟,范围为 136 至 508 分钟),平均住院时间为 2.7 天(中位数为 2 天,范围为 1 至 7 天)。7 例患者发生并发症,2 例发生邻近节段病变。术前冠状 Cobb 角平均为 35.1 度(中位数为 31 度,范围为 13 至 63 度),术后矫正为 15.7 度(中位数为 10.5 度,范围为 2 至 59 度)(p<0.005)。术前 NDI 平均为 24.9(中位数为 26,范围为 6 至 37),术后降至 17.8(中位数为 18,范围为 7 至 30)(p<0.02)。结论:颈椎侧凸的手术治疗可以矫正畸形,改善患者的预后。但可能会出现更高的并发症发生率。