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颈椎间盘置换术后椎体后缘骨质溶解所致的脊髓型颈椎病

Cervical Myelopathy Induced by Posterior Vertebral Body Osteolysis after Cervical Disc Arthroplasty.

作者信息

Choi Man Kyu, Lee Jun Ho

机构信息

Department of Neurosurgery, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea.

出版信息

J Korean Neurosurg Soc. 2023 Sep;66(5):591-597. doi: 10.3340/jkns.2022.0190. Epub 2023 Mar 21.

Abstract

Cervical disc arthroplasty (CDA) has become more widespread and diverges from the conventional technique used in anterior cervical fusion for cervical degenerative disc disease. As arthroplasty has become a popular treatment option, few complications have been reported in the literature. These include subsidence, expulsion, posterior avulsion fractures, heterotopic ossification, and osteolysis. One of the critical complications is osteolysis, but current studies on this subject are limited in terms of not elucidating the incidence, etiology, and consequences. The authors present two cases, who presented with clinical signs of gradually worsening myelopathy induced by posterior vertebral body osteolysis, 2 years after CDA. Subsequently, the patient underwent posterior decompression and fusion without prosthesis removal. Postoperatively, the clinical symptoms gradually resolved, with no severe deficits. The present rare cases highlight the osteolysis that occurs after CDA, which can cause cervical myelopathy, and suggest spine surgeons to be alert to this fatal complication.

摘要

颈椎间盘置换术(CDA)已变得更为普遍,并且与用于治疗颈椎退行性椎间盘疾病的传统前路颈椎融合技术有所不同。随着关节成形术成为一种流行的治疗选择,文献中报道的并发症较少。这些并发症包括下沉、脱出、后撕脱骨折、异位骨化和骨溶解。关键并发症之一是骨溶解,但目前关于该主题的研究在阐明发病率、病因和后果方面有限。作者介绍了两例病例,他们在CDA术后2年出现由椎体后缘骨溶解引起的脊髓病逐渐加重的临床症状。随后,患者接受了后路减压融合术,未取出假体。术后,临床症状逐渐缓解,无严重功能障碍。目前这两例罕见病例突出了CDA术后发生的骨溶解,其可导致颈椎脊髓病,并建议脊柱外科医生警惕这种致命并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4e1/10483154/d872dc8439d0/jkns-2022-0190f1.jpg

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