Hutzelmann A, Freund M, Palmié S, Wagner D, Benz T
Klinik für Radiologische Diagnostik, Christian-Albrechts-Universität zu Kiel.
Rofo. 1997 Jan;166(1):40-3. doi: 10.1055/s-2007-1015375.
The usual treatment in cervical nerve root compression syndrome is the ventral fusion with bone cement. We examined the influence of this interponate on the postoperative changes of the cervical spine.
33 patients were followed-up postoperatively over 6 months, who were treated with 39 ventral fusions because of cervical myelopathy. The lateral view of the cervical spine was used to measure the size of the bone cement interponate, the height of the intervertebral body space and the angle of both vertebral bodies.
There was no change on the size of the interponate. Postoperatively there was a slight enlargement of the intervertebral body space. During further follow-up examinations there was a decrease to the preoperative size because of the destruction of the endplates. Similar to this observation, there was a change of the angle in the operated segment. First there was a decrease of the angle, later an increase. 6 months postoperatively the preoperatively status was re-attained. Clinical examination of the patients revealed new neurologic deficits in 10% of the cases.
We conclude that the postoperative deficits can be only partially explained because the structural changes occur with both the uncomplicated postoperative courses and in patients with postoperative deficits.
颈椎神经根压迫综合征的常规治疗方法是使用骨水泥进行前路融合术。我们研究了这种植入物对颈椎术后变化的影响。
对33例因颈椎病接受39次前路融合术的患者进行了术后6个月以上的随访。利用颈椎侧位片测量骨水泥植入物的大小、椎体间隙高度以及两个椎体的角度。
植入物大小无变化。术后椎体间隙略有增大。在进一步的随访检查中,由于终板破坏,间隙尺寸减小至术前大小。与此观察结果类似,手术节段的角度也发生了变化。首先角度减小,随后增大。术后6个月恢复到术前状态。对患者的临床检查显示,10%的病例出现了新的神经功能缺损。
我们得出结论,术后神经功能缺损只能部分得到解释,因为无论是术后恢复顺利的患者还是有术后神经功能缺损的患者都会出现结构变化。