Pitzen T, Drumm J, Berthold C, Ostrowski G, Heiler U, Ruf M
Zentrum für Wirbelsäulenchirurgie, Orthopädie, Traumatologie, SRH Klinikum Karlsbad, 76307, Karlsbad, Langensteinbach, Deutschland.
Orthopade. 2018 Jun;47(6):467-473. doi: 10.1007/s00132-018-3562-3.
Motion preserving surgery within the cervical spine may be performed by special implants, for example, c spine disc prosthesis or total disc replacement (cTDR), or by simple decompression of the cervical nerve roots. However, also fusion surgery may be performed with good results. Here, we summarize indications as well as contraindications for motion preserving techniques and indications for fusion surgery. cTDR is indicated in special cases of soft disc herniation, especially in younger individuals without signs of myelopathy. Posterior decompression may be used as an alternative, especially if anterior surgery is not possible. If degeneration is severe, in the presence of kyphosis, severe canal encroachment, instability, and in cases of myelopathy, cervical spine fusion seems to be the better way.
颈椎的保留运动手术可通过特殊植入物进行，例如颈椎间盘假体或全椎间盘置换术（cTDR），也可通过简单的颈椎神经根减压术进行。然而，融合手术也可取得良好效果。在此，我们总结了保留运动技术的适应证和禁忌证以及融合手术的适应证。cTDR适用于软性椎间盘突出的特殊情况，尤其是没有脊髓病迹象的年轻患者。后路减压可作为替代方法，特别是在前路手术不可行时。如果退变严重，存在后凸、严重的椎管侵占、不稳定以及脊髓病的情况，颈椎融合术似乎是更好的选择。
