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前路椎体切除及碳聚醚醚酮器械钢板固定治疗颈椎转移瘤:临床及影像学结果

Anterior Corpectomy and Plating with Carbon-PEEK Instrumentation for Cervical Spinal Metastases: Clinical and Radiological Outcomes.

作者信息

Trungu Sokol, Ricciardi Luca, Forcato Stefano, Scollato Antonio, Minniti Giuseppe, Miscusi Massimo, Raco Antonino

机构信息

Neurosurgery Unit, Cardinale G. Panico Hospital, 73039 Tricase, Italy.

NESMOS Department, Sant'Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy.

出版信息

J Clin Med. 2021 Dec 16;10(24):5910. doi: 10.3390/jcm10245910.

Abstract

: Anterior cervical corpectomy and plating has been recognized as a valuable approach for the surgical treatment of cervical spinal metastases. This study aimed to report the surgical, clinical and radiological outcomes of anterior carbon-PEEK instrumentations for cervical spinal metastases. : Demographical, clinical, surgical and radiological data were collected from 2017 to 2020. The Neck Disability Index (NDI) questionnaire for neck pain, EORTC QLQ-C30 questionnaire for quality of life, Nurick scale for myelopathy and radiological parameters (segmental Cobb angle and cervical lordosis) were collected before surgery, at 6 weeks postoperatively and follow-up. : Seventeen patients met inclusion criteria. Mean age was 60.9 ± 7.6 years and mean follow-up was 12.9 ± 4.0 months. The NDI (55.4 ± 11.7 to 25.1 ± 5.4, < 0.001) scores and the EORTC QLQ-C30 global health/QoL significantly improved postoperatively and at the last follow-up. The segmental Cobb angle (10.7° ± 5.6 to 3.1° ± 2.2, < 0.001) and cervical lordosis (0.9° ± 6.7 to -6.2 ± 7.8, = 0.002) significantly improved postoperatively. Only one minor complication (5.9%) was recorded. : Carbon/PEEK implants represent a safe alternative to commonly used titanium ones and should be considered in cervical spinal metastases management due to their lower artifacts in postoperative imaging and radiation planning. Further larger comparative and cost-effectiveness studies are needed to confirm these results.

摘要

颈椎椎体次全切除并植骨融合内固定术已被公认为是治疗颈椎脊柱转移瘤的一种有效手术方法。本研究旨在报告前路碳-聚醚醚酮(PEEK)内固定治疗颈椎脊柱转移瘤的手术、临床及影像学结果。:收集2017年至2020年的人口统计学、临床、手术及影像学数据。术前、术后6周及随访时收集颈部疼痛的颈部功能障碍指数(NDI)问卷、生活质量的欧洲癌症研究与治疗组织核心问卷(EORTC QLQ-C30)、脊髓病的Nurick分级及影像学参数(节段性Cobb角和颈椎前凸)。:17例患者符合纳入标准。平均年龄为60.9±7.6岁,平均随访时间为12.9±4.0个月。术后及末次随访时,NDI评分(从55.4±11.7降至25.1±5.4,P<0.001)及EORTC QLQ-C30总体健康状况/生活质量显著改善。术后节段性Cobb角(从10.7°±5.6改善至3.1°±2.2,P<0.001)及颈椎前凸(从0.9°±6.7改善至-6.2±7.8,P=0.002)显著改善。仅记录到1例轻微并发症(5.9%)。:碳/PEEK植入物是常用钛植入物的安全替代品,由于其在术后影像学和放射治疗计划中的伪影较少,在颈椎脊柱转移瘤的治疗中应予以考虑。需要进一步开展更大规模的对比研究和成本效益研究以证实这些结果。

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