An Tae Yong, Kim Ji-Yoon, Lee Young-Seok
Department of Neurosurgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
Department of Anesthesiology, Pain and Critical Care Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
Korean J Neurotrauma. 2021 Sep 3;17(2):126-135. doi: 10.13004/kjnt.2021.17.e23. eCollection 2021 Oct.
Anterior cervical corpectomy using a titanium mesh cage may result in delayed nonunion and thus a change in cervical alignment, and patients may require revision surgery. We investigated the radiologic and clinical outcomes of cervical corpectomy and the risk factors for subsidence.
We studied 74 patients who underwent single-level anterior cervical corpectomy for cervical spondylotic myelopathy with or without ossification of the posterior longitudinal ligament between 2007 and 2014. Graft subsidence was considered present when there was a reduction in the anterior and posterior heights by an average of 4 mm or more 2 years after the operation. We measured cervical parameters before surgery, immediately after surgery, and 6, 12, and 24 months after surgery. The clinical outcomes were the neck and arm visual analog scale scores and reoperation rate.
In the subsidence group, these values gradually decreased over the 24 months. The radiologic parameters did not differ between the 2 groups for 24 months after the onset of subsidence. There were no differences in clinical outcome or reoperation rate. In the analysis of the risk factors, subsidence occurred with a large T1 slope and a large change in the C27 Cobb angle (=0.020 and =0.026, respectively).
Subsidence gradually occurred after single-level anterior cervical corpectomy for up to 24 months. However, the presence of subsidence did not affect the radiologic and clinical outcomes. When the T1 slope was large and the C27 Cobb angle change was severe, more subsidence occurred.
采用钛网笼进行颈椎前路椎体次全切除可能导致延迟性骨不连，进而引起颈椎排列改变，患者可能需要翻修手术。我们研究了颈椎椎体次全切除的影像学和临床结果以及下沉的危险因素。
我们研究了2007年至2014年间因脊髓型颈椎病接受单节段颈椎前路椎体次全切除且伴有或不伴有后纵韧带骨化的74例患者。当术后2年前后高度平均降低4mm或更多时，认为存在植骨下沉。我们在手术前、手术后即刻以及术后6、12和24个月测量颈椎参数。临床结果为颈部和手臂视觉模拟量表评分及再次手术率。
在下沉组中，这些值在24个月内逐渐下降。下沉开始后24个月内，两组的影像学参数无差异。临床结果或再次手术率无差异。在危险因素分析中，T1斜率大及C27 Cobb角变化大时出现下沉（分别为=0.020和=0.026）。
单节段颈椎前路椎体次全切除后下沉可持续发生长达24个月。然而，下沉的存在并不影响影像学和临床结果。当T1斜率大且C27 Cobb角变化严重时，下沉更易发生。
