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颈椎椎体次全切除术的管理考量:更新的适应症及未来方向

Management Considerations for Cervical Corpectomy: Updated Indications and Future Directions.

作者信息

Foreman Marco, Foster Devon, Gillam Wiley, Ciesla Christopher, Lamprecht Chris, Lucke-Wold Brandon

机构信息

Department of Neurosurgery, University of Florida, Gainesville, FL 32610, USA.

Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA.

出版信息

Life (Basel). 2024 May 21;14(6):651. doi: 10.3390/life14060651.

Abstract

Together, lower back and neck pain are among the leading causes of acquired disability worldwide and have experienced a marked increase over the past 25 years. Paralleled with the increasing aging population and the rise in chronic disease, this trend is only predicted to contribute to the growing global burden. In the context of cervical neck pain, this symptom is most often a manifestation of cervical degenerative disc disease (DDD). Traditionally, multilevel neck pain related to DDD that is recalcitrant to both physical and medical therapy can be treated with a procedure known as cervical corpectomy. Presently, there are many flavors of cervical corpectomy; however, the overarching goal is the removal of the pain-generating disc via the employment of the modern anterior approach. In this review, we will briefly detail the pathophysiological mechanism behind DDD, overview the development of the anterior approach, and discuss the current state of treatment options for said pathology. Furthermore, this review will also add to the current body of literature surrounding updated indications, surgical techniques, and patient outcomes related to cervical corpectomy. Finally, our discussion ends with highlighting the future direction of cervical corpectomy through the introduction of the "skip corpectomy" and distractable mesh cages.

摘要

下背部疼痛和颈部疼痛共同位列全球后天性残疾的主要原因,且在过去25年中显著增加。随着人口老龄化加剧和慢性病增多,这一趋势预计只会加重全球负担。在颈部疼痛方面,这种症状通常是颈椎间盘退变疾病(DDD)的表现。传统上,与DDD相关的、对物理和药物治疗均无效的多节段颈部疼痛可通过一种称为颈椎椎体次全切除术的手术来治疗。目前,颈椎椎体次全切除术有多种术式;然而,总体目标是通过采用现代前路手术方法切除产生疼痛的椎间盘。在本综述中,我们将简要详述DDD背后的病理生理机制,概述前路手术方法的发展,并讨论针对该病症的当前治疗选择状况。此外,本综述还将补充当前围绕颈椎椎体次全切除术的更新适应症、手术技术及患者预后的文献。最后,我们的讨论通过引入“跳跃式椎体次全切除术”和可撑开椎间融合器来突出颈椎椎体次全切除术的未来方向而结束。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be73/11205077/3039b142debe/life-14-00651-g001.jpg

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