Wu Ting-Kui, Wang Bei-Yu, Cheng Ding, Rong Xin, Lou Ji-Gang, Hong Ying, Liu Hao
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.
J Clin Neurosci. 2017 Jun;40:102-108. doi: 10.1016/j.jocn.2017.02.030. Epub 2017 Feb 27.
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.
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。
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