Safaee Michael M, Tan Lee A, Ames Christopher P
Department of Neurological Surgery, University of California, San Francisco, CA, USA.
J Spine Surg. 2020 Mar;6(1):274-279. doi: 10.21037/jss.2020.01.07.
Posterior cervical osteotomies are powerful techniques for the correction of rigid cervical deformity. These include a variety of subtypes including partial facet joint resection, complete facet joint resection, opening wedge osteotomy (OWO), and closing wedge osteotomy (CWO). The partial facet joint resection provides limited lordosis but can be applied across multiple levels and provides bony surface for fusion. Complete facet joint resection can also be performed across multiple segments for a cumulative effect and like the partial facet joint resection requires mobility of the anterior column. The OWO is traditionally performed at C7 and involves complete a complete laminectomy, facetectomy, and pediculectomy with special care to fully decompress the C8 nerve roots prior to osteotomy closure. The osteotomy utilizes a fulcrum of rotation in the middle column with shortening of the posterior column and lengthening of the anterior column with an osteoclastic fracture that must be performed with significant care. The CWO is similar to an OWO with the addition of an osteotomy into the vertebral body that is closed like a pedicle subtraction osteotomy (PSO). The goal of this review article is to summarize posterior osteotomy techniques for cervical deformity correction.
颈椎后路截骨术是矫正僵硬颈椎畸形的有效技术。这些技术包括多种亚型，包括部分小关节切除术、全小关节切除术、开放楔形截骨术（OWO）和闭合楔形截骨术（CWO）。部分小关节切除术可提供有限的前凸，但可应用于多个节段，并为融合提供骨面。全小关节切除术也可在多个节段进行以产生累积效应，并且与部分小关节切除术一样，需要前柱具有可动性。传统上，OWO在C7节段进行，包括完整的椎板切除术、小关节切除术和椎弓根切除术，截骨闭合前需特别注意充分减压C8神经根。截骨术利用中柱作为旋转支点，后柱缩短，前柱延长，通过骨破折性骨折实现，操作时必须格外小心。CWO与OWO相似，只是增加了椎体截骨，截骨闭合方式类似椎弓根减法截骨术（PSO）。这篇综述文章的目的是总结颈椎畸形矫正的后路截骨技术。
