Yazdanshenas Hamed, Osias Ethan, Hwang Richard, Park Don Y, Lord Elizabeth, Shamie Arya N
Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
Family Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
J Craniovertebr Junction Spine. 2022 Jan-Mar;13(1):48-54. doi: 10.4103/jcvjs.jcvjs_150_21. Epub 2022 Mar 9.
Cervical radiculopathy is a relatively common problem that often affects individuals in their 5 decade. Most cases resolve with conservative treatment, but when unsuccessful, many opt for surgical intervention. Anterior cervical discectomy and fusion is currently considered the gold standard for the surgical management of cervical radiculopathy. One promising alternative, the DTRAX facet system is minimally invasive and may significantly reduce or eliminate cervical radicular symptoms. This case series and literature review looks to investigate the safety and efficacy of the DTRAX facet system in treating cervical radiculopathy.
This retrospective analysis was performed by chart review of patients who underwent posterior cervical fusion and received the DTRAX spinal implant at University of California, Los Angeles within the last 8 years. Patient charts were located using the surgical cases report function of Epic electronic medical record, and patients were included in the study if they received a DTRAX implant during the stated time period. Data were compiled and analyzed using Microsoft Excel.
A total of 14 patient charts were reviewed. Of the 14, there were no immediate postoperative complications. One international patient was subsequently lost to follow-up, and of the remaining 13, mean follow-up duration was 273 days, with a range of 15-660 days. All but one reported improvement of symptoms postoperatively, there were no device failures, and no reoperations were required. There were similar outcomes in patients who received single versus multilevel operations.
The findings of this retrospective study of 14 patients who received the DTRAX facet system over the last 8 years support the conclusions of previous studies that DTRAX is safe and effective. In addition, this is the first study to look for differences in outcomes between single and multi-level DTRAX operations, of which there were none. Further investigation with larger cohorts should be conducted as DTRAX becomes more widely adopted in order to verify its safety and efficacy in various clinical scenarios.
神经根型颈椎病是一个相对常见的问题，常影响50多岁的人群。大多数病例通过保守治疗可缓解，但治疗失败时，许多人会选择手术干预。目前，颈椎前路椎间盘切除融合术被认为是神经根型颈椎病外科治疗的金标准。一种有前景的替代方法，即DTRAX椎间关节系统，具有微创性，可能显著减轻或消除神经根型颈椎病症状。本病例系列及文献综述旨在研究DTRAX椎间关节系统治疗神经根型颈椎病的安全性和有效性。
通过回顾性分析过去8年内在加利福尼亚大学洛杉矶分校接受颈椎后路融合术并植入DTRAX脊柱植入物的患者病历进行此项研究。使用Epic电子病历的手术病例报告功能查找患者病历，在规定时间段内接受DTRAX植入物的患者纳入本研究。使用Microsoft Excel收集和分析数据。
共查阅了14份患者病历。这14例患者术后均无即刻并发症。1例国际患者随后失访，其余13例患者的平均随访时间为273天，范围为15至660天。除1例患者外，所有患者均报告术后症状改善，无器械故障，无需再次手术。接受单节段与多节段手术的患者结果相似。
这项对过去8年中接受DTRAX椎间关节系统的14例患者的回顾性研究结果支持先前研究的结论，即DTRAX安全有效。此外，这是第一项研究单节段与多节段DTRAX手术结果差异的研究，结果显示并无差异。随着DTRAX被更广泛采用，应进行更大样本量的进一步研究，以验证其在各种临床情况下的安全性和有效性。
