Tarantino Roberto, Nigro Lorenzo, Donnarumma Pasquale, Rullo Marika, Santoro Antonio, Delfini Roberto
Department of Neurology and Psychiatry, Division of Neurosurgery, "Sapienza" University of Rome, Rome, Italy.
Department of Psychology, "Sapienza" University of Rome, Rome, Italy.
Neurosurg Rev. 2017 Apr;40(2):281-286. doi: 10.1007/s10143-016-0770-3. Epub 2016 Aug 2.
After single or multilevel cervical corpectomy for the treatment of different diseases, many surgical options have been proposed over the years. As a single device, a winged expandable titanium cage (WETC) has been developed. We report the use of this device and our clinical results at 24 months of follow-up in a prospective series of 34 patients who underwent single or multilevel corpectomy for the treatment of cervical spondylosis. Thirty-four consecutive patients underwent single or multilevel cervical corpectomy followed by the insertion of a WETC for the treatment of cervical spondylosis at Department of Neurology and Psychiatry "Sapienza" University of Rome, Italy, from May 2011 to May 2013. Patients affected by cervical spondylosis with cervical lordosis >0° were included. Patients affected by cervical lordosis <0°, osteoporosis, or other cervical diseases were excluded. The mean postsurgical Nurick's grade was significantly lower than the mean presurgical Nurick's grade (mean = 0.98 for postsurgical Nurick's grade and mean = 2.42 for presurgical Nurick's grade). Four patients (11.7 %) presented subsidence respectively of 1, 2, 2, and 3 mm at 24 months of radiological follow-up. Postoperative complications occurred in five patients (14.7 %). Our case series at 24 months of follow-up demonstrates that the use of a WETC obtains good clinical results after single or multiple corpectomy in patients not affected by osteoporosis who do not require cervical lordosis correction. During the insertion of the device, an adequate preparation of the end plates is suggested and their over distraction should be avoided.
多年来，针对不同疾病的单节段或多节段颈椎椎体次全切除术后，人们提出了多种手术方案。作为一种单一器械，翼状可扩张钛笼（WETC）已被研发出来。我们报告了该器械的使用情况以及对34例因颈椎病接受单节段或多节段椎体次全切除术患者进行24个月随访的临床结果。2011年5月至2013年5月，意大利罗马“萨皮恩扎”大学神经精神病学系的34例连续患者接受了单节段或多节段颈椎椎体次全切除术，随后植入WETC以治疗颈椎病。纳入颈椎前凸>0°的颈椎病患者。排除颈椎前凸<0°、骨质疏松或其他颈椎疾病患者。术后Nurick分级的平均值显著低于术前Nurick分级的平均值（术后Nurick分级平均值=0.98，术前Nurick分级平均值=2.42）。在影像学随访24个月时，4例患者（11.7%）分别出现了1、2、2和3毫米的下沉。5例患者（14.7%）发生了术后并发症。我们24个月随访的病例系列表明，对于不需要矫正颈椎前凸且未患骨质疏松症的患者，单节段或多节段椎体次全切除术后使用WETC可获得良好的临床效果。在植入器械时，建议对终板进行充分准备，并避免过度撑开。
