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混合手术治疗跳跃节段颈椎间盘退变疾病的临床和影像学特征:至少24个月的随访

Clinical and radiographic features of hybrid surgery for the treatment of skip-level cervical degenerative disc disease: A minimum 24-month follow-up.

作者信息

Wu Ting-Kui, Wang Bei-Yu, Cheng Ding, Rong Xin, Lou Ji-Gang, Hong Ying, Liu Hao

机构信息

Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Rd, Sichuan 610041, China.

Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Rd, Sichuan 610041, China.

出版信息

J Clin Neurosci. 2017 Jun;40:102-108. doi: 10.1016/j.jocn.2017.02.030. Epub 2017 Feb 27.


DOI:10.1016/j.jocn.2017.02.030
PMID:28246009
Abstract

We describe the radiographic changes of IS and investigate the safety and feasibility of hybrid surgery (HS) coupling cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) for the treatment of skip-level cervical degenerative disc disease (CDDD). Twenty-seven patients who received HS were retrospectively reviewed. Clinical evaluation based on the Japanese Orthopedic Association (JOA) and Neck Disability Index (NDI) and Visual Analog Scale (VAS) scores. Radiographic parameters included cervical alignment (CA), functional spine unite (FSU) angle of intermediated segment (IS), range of motion (ROM) and intervertebral disc height (IDH). Data regarding radiographic changes at IS were collected. The mean follow-up duration of 30.10months. Compared with preoperative value, JOA, NDI and VAS scores significantly improved after surgery (p<0.05). The CA was recovered significantly after surgery (p<0.05). There was no significant difference in the FSU angle and the IDH of IS between before and at 24months postoperatively (p>0.05). The ROM of IS significantly decreased at the first week after surgery (p<0.05), was similar to preoperative value at 3months postoperatively and significantly increased after 6months (p<0.05). Radiographic changes at IS were observed in 2 patients and Class II Heterotopic ossification (HO) was detected in 2 patients. HS is a safe and feasible alternative procedure for the treatment of skip-level CDDD. It preserved the IS intact and achieved satisfactory clinical and radiographic outcomes over a 24-month follow-up.

摘要

我们描述了中间节段(IS)的影像学变化,并研究了联合颈椎间盘置换术(CDA)和颈椎前路椎间盘切除融合术(ACDF)的混合手术(HS)治疗跳跃型颈椎退行性椎间盘疾病(CDDD)的安全性和可行性。对27例行HS手术的患者进行回顾性分析。基于日本骨科协会(JOA)、颈部残疾指数(NDI)和视觉模拟量表(VAS)评分进行临床评估。影像学参数包括颈椎对线(CA)、中间节段(IS)的功能脊柱单元(FSU)角度、活动范围(ROM)和椎间盘高度(IDH)。收集有关IS影像学变化的数据。平均随访时间为30.10个月。与术前值相比,术后JOA、NDI和VAS评分显著改善(p<0.05)。术后CA明显恢复(p<0.05)。术后24个月时,IS的FSU角度和IDH与术前相比无显著差异(p>0.05)。术后第1周IS的ROM显著降低(p<0.05),术后3个月与术前值相似,术后6个月显著增加(p<0.05)。2例患者观察到IS的影像学变化,2例患者检测到Ⅱ级异位骨化(HO)。HS是治疗跳跃型CDDD的一种安全可行的替代手术。它保持了IS完整,并在24个月的随访中取得了满意的临床和影像学结果。

相似文献

[1]
Clinical and radiographic features of hybrid surgery for the treatment of skip-level cervical degenerative disc disease: A minimum 24-month follow-up.

J Clin Neurosci. 2017-6

[2]
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[3]
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[4]
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[5]
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引用本文的文献

[1]
Contiguous versus skip discectomy and fusion in cervical disc herniation: Do we need to fuse the normal intermediate segment?

J Craniovertebr Junction Spine. 2025

[2]
Overloaded Vertebral Body Following Consecutive Three-Level Hybrid Surgery Comparing with Anterior Cervical Discectomy and Fusion.

Orthop Surg. 2024-12

[3]
Segment selection for fusion and artificial disc replacement in the hybrid surgical treatment of noncontiguous cervical spondylosis: a finite element analysis.

Front Bioeng Biotechnol. 2024-4-3

[4]
Anterior Full-endoscopic Single-port Double Transcorporeal Spinal Cord Decompression for Noncontinuous Two-segment Cervical Spondylotic Myelopathy: A Technical Note.

Orthop Surg. 2024-3

[5]
Biomechanical effects of hybrid constructions in the treatment of noncontinuous cervical spondylopathy: a finite element analysis.

J Orthop Surg Res. 2023-1-20

[6]
Diagnostic Investigations as a Basis for Optimising Surgical Management of Vertebrobasilar Insufficiency Syndrome.

Front Surg. 2022-5-16

[7]
Surgical strategy used in multilevel cervical disc replacement and cervical hybrid surgery: Four case reports.

World J Clin Cases. 2020-9-6

[8]
The Changes in Cervical Biomechanics After CTDR and Its Association With Heterotopic Ossification: A Systematic Review and Meta-analysis.

Global Spine J. 2021-5

[9]
Hybrid decompression and reconstruction technique for cervical spondylotic myelopathy: case series and review of the literature.

J Spine Surg. 2020-3

[10]
Cervical Total Disc Replacement and Heterotopic Ossification: A Review of Literature Outcomes and Biomechanics.

Asian Spine J. 2021-2

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