Wu Jinhui, Hu Miao, Tao Zhengbo, Zhou Xin, Jiang Heng, Lin Tao, Ma Jun, Gao Rui, Wang Ce, Zhou Xuhui
Department of Orthopedics, Changzheng Hospital, Shanghai, China.
Department of Orthopedics, Shanghai General Hospital, Shanghai, China.
Front Surg. 2023 Mar 17;10:1123397. doi: 10.3389/fsurg.2023.1123397. eCollection 2023.
To propose and validate a new classification of surgical methods for patients with subaxial cervical hemivertebrae.
This article reviewed cases diagnosed with subaxial cervical hemivertebrae in our hospital from January 2008 to December 2019. The results of preoperative (initial visit), postoperative and/or final follow-up were assessed using the Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI) score, spinal balance parameters, and Scoliosis Research Society-22 Questionnaire (SRS-22). We also performed a reliability study to assess this classification.
The classification includes three types. Each type can be divided into two subtypes, and a preliminary algorithm is proposed. Type I: There is an obvious appearance deformity in the neck, there are hemivertebrae in the cervical spine, and only a single hemivertebra of the subaxial cervical hemivertebra needs to be resected. Type II: There is an obvious appearance deformity in the neck, there are hemivertebrae in the cervical spine, and multiple subaxial cervical hemivertebrae need to be removed. Type III: No apparent deformity in the neck, at least one subaxial cervical hemivertebra existed or Klipper-Feil syndrome. Each type is divided into two subtypes, A and B, according to whether the upper and lower adjacent vertebral bodies of the rescected hemivertebra(e) are fused. We propose corresponding treatment methods for different types. We included a total of 121 patients and reviewed the prognosis for each type of patient. All patients achieved satisfactory results. The reliability study showed that the mean interobserver agreement was 91.8% (89.3%-93.4%), and the value was 0.845 (0.800-0.875). The intraobserver agreement ranged from 93.4% to 97.5%, with a mean value of 0.929 (0.881 to 0.954).
In our study, we proposed and validated a new classification of subaxial cervical hemivertebrae and proposed corresponding treatment plans for different classifications.
提出并验证一种针对下颈椎半椎体畸形患者的手术方法新分类。
本文回顾了2008年1月至2019年12月在我院诊断为下颈椎半椎体畸形的病例。使用日本骨科学会（JOA）评分、颈部功能障碍指数（NDI）评分、脊柱平衡参数和脊柱侧凸研究学会22项问卷（SRS-22）评估术前（初诊）、术后和/或最终随访结果。我们还进行了一项可靠性研究以评估该分类。
该分类包括三种类型。每种类型可分为两个亚型，并提出了初步算法。I型：颈部有明显外观畸形，颈椎存在半椎体，仅需切除下颈椎半椎体中的单个半椎体。II型：颈部有明显外观畸形，颈椎存在半椎体，需要切除多个下颈椎半椎体。III型：颈部无明显畸形，存在至少一个下颈椎半椎体或Klippel-Feil综合征。根据切除的半椎体上下相邻椎体是否融合，每种类型分为A、B两个亚型。我们针对不同类型提出了相应的治疗方法。我们共纳入121例患者，并回顾了每种类型患者的预后。所有患者均取得满意结果。可靠性研究表明，观察者间平均一致性为91.8%（89.3%-93.4%），kappa值为0.845（0.800-0.875）。观察者内一致性范围为93.4%至97.5%，平均kappa值为0.929（0.881至0.954）。
在我们的研究中，我们提出并验证了一种下颈椎半椎体畸形的新分类，并针对不同分类提出了相应的治疗方案。
