Lenzi Jacopo, Nardone Antonio, Passacantilli Emiliano, Caporlingua Alessandro, Lapadula Gennaro, Caporlingua Federico
Neurological Center of Latium, Neurosurgery, Rome, Italy.
Department of Neurology and Psychiatry, Neurosurgery, "Sapienza" University of Rome, Rome, Italy.
World Neurosurg. 2017 Apr;100:7-14. doi: 10.1016/j.wneu.2016.12.125. Epub 2017 Jan 5.
Single-level cervical radiculopathy may be treated conservatively with cervical tractions. Posterior cervical transfacet fusion with a facetal spacer is a viable option. The aim of the present study is to compare posterior cervical transfacet fusion with conservative physical treatment in single-level cervical radiculopathy.
A total of 80 patients were randomized in 2 groups, a surgical group in which patients were given posterior cervical transfacet fusion and a traction group in which patients were treated conservatively with mechanical cervical tractions. Visual analog scale for arm and neck, Neck Disability Index, and Short Form-36 (SF-36) questionnaires were administered preoperatively and after treatment up to 12 months.
After treatment, visual analog scale arm scores were greater in traction group (4.7 vs. 1.5 the day after treatment) and at follow-up controls (traction group vs. surgical group: 5.3 vs. 0.6 at 1 month, 3.6 vs. 0.3 at 6 months, 1.8 vs. 0.2 at 12 months). Neck Disability Index scores were lower in the surgical group (surgical group vs. traction group: 4.4 vs. 20.3 at 1 month, 1.3 vs. 10.5 at 6 months). SF-36 scores were greater in the surgical group (surgical group vs. traction group: 96 vs. 70 at 1 month, 96.5 vs. 82.6 at 6 months). Neck disability index and SF-36 scores were superimposable between the groups at 12-month follow-up. No adjacent-segment arthrosis or late complications were reported at 1-year follow-up in the surgical group.
posterior cervical transfacet fusion is a safe and effective procedure to treat single-level cervical radiculopathy.
单节段颈椎神经根病可通过颈椎牵引进行保守治疗。后路经关节突融合并使用关节突间隔器是一种可行的选择。本研究的目的是比较后路经关节突融合术与保守物理治疗在单节段颈椎神经根病中的疗效。
总共80例患者被随机分为两组，一组为手术组，患者接受后路经关节突融合术；另一组为牵引组，患者接受机械颈椎牵引保守治疗。术前及治疗后长达12个月时，采用手臂和颈部视觉模拟量表、颈部功能障碍指数以及简明健康状况调查量表（SF-36）问卷进行评估。
治疗后，牵引组的手臂视觉模拟量表评分更高（治疗后第1天：4.7 vs. 1.5），且在随访对照中也是如此（牵引组与手术组相比：1个月时为5.3 vs. 0.6，6个月时为3.6 vs. 0.3，12个月时为1.8 vs. 0.2）。手术组的颈部功能障碍指数评分更低（手术组与牵引组相比：1个月时为4.4 vs. 20.3，6个月时为1.3 vs. 10.5）。手术组的SF-36评分更高（手术组与牵引组相比：1个月时为96 vs. 70，6个月时为96.5 vs. 82.6）。在12个月随访时，两组的颈部功能障碍指数和SF-36评分相近。手术组在1年随访时未报告相邻节段关节病或晚期并发症。
后路经关节突融合术是治疗单节段颈椎神经根病的一种安全有效的方法。
