Pescatori Lorenzo, Tropeano Maria Pia, Visocchi Massiliano, Grasso Giovanni, Ciappetta Pasqualino
Department of Neurosurgery, Sant'Eugenio Hospital, Rome, Italy; Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
Humanitas Clinical and Research Hospital & Department of Neurosciences, Humanitas University, Rozzano, Italy.
World Neurosurg. 2020 Aug;140:548-555. doi: 10.1016/j.wneu.2020.03.100.
Cervical spondylotic myelopathy (CSM) is a degenerative disease that represents the most common spinal cord disorder in adults. The best treatment option has remained controversial. We performed a prospective study to evaluate the clinical, radiographic, and neurophysiologic outcomes for anterior cervical corpectomy in the treatment of CSM.
From January 2011 to January 2017, 60 patients with CSM were prospectively enrolled in the present study. The patients were divided according to the modified Japanese Orthopaedic Association scale (mJOA) score into 2 groups: group A, patients with mild to moderate CSM (mJOA score ≥13); and group B, patients with severe myelopathy (mJOA score <13). Data were collected for each participating subject, including demographic information, symptoms, medical history, radiologic and neurophysiologic features, and functional impairment.
Of the 60 patients, 35 were men (58.3%) and 25 were women (41.7%). Their average age was 57.48 ± 10.60 years. The mean symptom duration was 25.33 ± 16.00 months; range, 3-57 months). Of the 60 patients, 22 had undergone single-level corpectomy and 36 multilevel corpectomy. A significant improvement in the motor evoked potentials was observed in both groups.
Single- and multilevel corpectomy are valid and safe options in the treatment of CSM. In the present prospective study, a statistically significant improvement in the mJOA score and neurophysiologic parameters was observed for both moderate and severe forms of CSM.
脊髓型颈椎病（CSM）是一种退行性疾病，是成人中最常见的脊髓疾病。最佳治疗方案一直存在争议。我们进行了一项前瞻性研究，以评估前路颈椎椎体次全切除术治疗CSM的临床、影像学和神经生理学结果。
从2011年1月至2017年1月，60例CSM患者前瞻性纳入本研究。根据改良日本骨科协会量表（mJOA）评分将患者分为2组：A组，轻度至中度CSM患者（mJOA评分≥13）；B组，严重脊髓病患者（mJOA评分<13）。收集每个参与受试者的数据，包括人口统计学信息、症状、病史、放射学和神经生理学特征以及功能障碍。
60例患者中，男性35例（58.3%），女性25例（41.7%）。他们的平均年龄为57.48±10.60岁。平均症状持续时间为25.33±16.00个月；范围为3-57个月）。60例患者中，22例行单节段椎体次全切除术，36例行多节段椎体次全切除术。两组均观察到运动诱发电位有显著改善。
单节段和多节段椎体次全切除术是治疗CSM的有效且安全的选择。在本前瞻性研究中，中度和重度CSM患者的mJOA评分和神经生理学参数均有统计学意义的改善。
