Ouchida Jun, Nakashima Hiroaki, Ito Sadayuki, Segi Naoki, Yamauchi Ippei, Imagama Shiro
Department of Orthopaedics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
J Clin Orthop Trauma. 2025 May 26;68:103074. doi: 10.1016/j.jcot.2025.103074. eCollection 2025 Sep.
Surgical techniques and technology for cervical spondylotic myelopathy (CSM) have demonstrated remarkable advancement during the past decade. This narrative review examines the evolution of surgical approaches and technological innovations, focusing on both anterior and posterior techniques. Anterior approaches have progressed through the development of endoscopic procedures, novel decompression methods such as vertebral body sliding osteotomy, and advanced implant materials including 3D-printed customized devices. Posterior approaches have evolved with the integration of endoscopic techniques and refined fixation methods, demonstrating reduced tissue trauma and improved outcomes. The integration of surgical assistance technologies, including navigation systems, robotics, and augmented reality, has enhanced surgical precision while potentially reducing procedural risks. While these advances show promising outcomes in terms of surgical precision and patient recovery, challenges persist regarding technology implementation and cost-effectiveness. Emerging technologies such as artificial intelligence for surgical planning, patient-specific implants, and adjunctive biological therapies may further improve CSM treatment. The optimal application of these innovations requires continued research and careful evaluation to establish their long-term efficacy and safety in clinical practice.
在过去十年中，用于治疗脊髓型颈椎病（CSM）的外科技术和工艺取得了显著进展。这篇叙述性综述探讨了手术方法和技术创新的演变，重点关注前路和后路技术。前路手术通过内镜手术的发展、诸如椎体滑动截骨术等新型减压方法以及包括3D打印定制装置在内的先进植入材料而取得了进展。后路手术随着内镜技术的整合和精细的固定方法而不断演变，显示出组织创伤减少和效果改善。包括导航系统、机器人技术和增强现实在内的手术辅助技术的整合提高了手术精度，同时有可能降低手术风险。虽然这些进展在手术精度和患者恢复方面显示出令人鼓舞的结果，但在技术实施和成本效益方面仍然存在挑战。诸如用于手术规划的人工智能、定制患者植入物和辅助生物疗法等新兴技术可能会进一步改善CSM的治疗。这些创新的最佳应用需要持续的研究和仔细的评估，以确定它们在临床实践中的长期疗效和安全性。
