Long-term outcomes following anterior foraminotomy for one- or two-level cervical radiculopathy
Long-term outcomes following anterior foraminotomy for one- or two-level cervical radiculopathy
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DOI：
10.1007/s00586-013-2712-x
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发表时间：
2013-07-01
影响因子：
2.8
通讯作者：
Kim, Joo Han
中科院分区：
文献类型：
--
作者：
Park, Youn-Kwan;Moon, Hong Joo;Kim, Joo Han
前孔切开术是治疗单侧神经根型颈椎病的一种手术治疗，可避免融合相关并发症，但其长期疗效仍有待研究。为了阐明房颤的疗效，作者回顾了关于这项技术结果的长期数据。在1999年11月至2005年6月期间接受房颤治疗的50名患者中，44名随访超过6年的患者进入了这项研究。研究的参数包括翻修次数、附加手术、VAS/NDI和Odom标准。在出院时，98%的患者报告有改善，尽管有20%的患者暂时有一些残留症状。术后无其他主要并发症发生。最后一次随访(FU，平均8.8年)，39例(89%)患者获得了良好的结果。无指标级再手术，但有症状的相邻节段退行性变需要另外两次手术(4.5%)。术后同侧肩痛6例(平均3.6年)。在最终的FU时，平片显示手术节段有显著的退变，导致活动范围减小。然而，节段前凸度的损失是最小的。在放射学上，仅有6%和11%的相邻节段退变发生在头节段和尾节段。在这项回顾研究中，接受房颤治疗的一或两个节段的颈椎神经根病患者显示出良好的长期预后，相邻节段退变最小。然而，应该收集更多的数据，以澄清与这些发现的可能联系，例如肩关节延迟问题和手术节段退变的加重。
Anterior foraminotomy (AF) is a surgical treatment for unilateral cervical radiculopathy that avoids fusion-related complications, but its long-term outcome has yet to be investigated. To clarify the efficacy of AF, the author retrospectively collected long-term data regarding the results of this technique.Of 50 patients who underwent AF between November 1999 and June 2005, those who were followed for more than 6 years (n = 44) were enrolled in this study. The parameters studied included the number of revisions, additional surgeries, VAS/NDI, and Odom's criteria. Plain radiographs were also obtained pre- and postoperatively.At discharge, 98 % of patients reported improvement, although 20 % temporarily experienced some residual symptoms. There were no other major postoperative complications. At final follow-up (FU, mean of 8.8 years), an excellent or good outcome was achieved in 39 patients (89 %). There was no index level reoperation required, but two additional operations for symptomatic adjacent-segment degeneration were needed (4.5 %). Six patients suffered from shoulder pain on the same side after surgery (mean onset: 3.6 years). At final FU, significant degeneration at the operated level was demonstrated on plain radiographs, resulting in a decreased range of motion. However, loss of lordosis of the segment was minimal. Radiographically, adjacent segment degeneration was noted in only 6 and 11 % at the cranial and caudal segments, respectively.In this retrospective study, patients who underwent AF for one- or two- level cervical radiculopathy showed a good long-term outcome with minimal adjacent segment degeneration. However, more data should be collected to clarify possible associations with these findings, such as delayed shoulder problems and aggravation of degeneration at the operated level.