Long-term follow-up after interbody fusion of the cervical spine
Long-term follow-up after interbody fusion of the cervical spine
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DOI：
10.1097/00024720-200404000-00001
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发表时间：
2004-04-01
影响因子：
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通讯作者：
van Loon, J
中科院分区：
文献类型：
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作者：
Goffin, J;Geusens, E;van Loon, J
这项工作的目的是增加数据的频率和严重程度的退行性影像学发现在相邻的颈椎前路椎间融合后，其临床影响，并有助于其发病机制的见解。180例接受颈椎前路椎间融合术治疗且随访时间>60个月的患者由独立研究者进行临床和影像学检查。对于所有患者，将长期Odom评分与术后6周获得的评分进行比较。对于脊髓病病例，将晚期Nurick和Odom评分与初始术后情况进行比较。对于相邻的椎间盘节段，在初始和长期随访时定义并评估放射学“退变评分”。在颈椎前路椎间融合术后的后期随访中，92%的病例发现相邻椎间盘节段的额外影像学退变，通常反映了临床恶化。这种额外变性的严重程度与手术后的时间间隔相关。年轻创伤患者和老年非创伤患者退变进展的相似性表明椎间融合的生物力学影响和既存退变疾病的自然进展都是相邻节段退变的触发因素。
The aim of this work was to add to the body of data on the frequency and severity of degenerative radiographic findings at adjacent levels after anterior cervical interbody fusion and on their clinical impact and to contribute to the insights about their pathogenesis. One hundred eighty patients who were treated by anterior cervical interbody fusion and who had a follow-up of >60 months were clinically and radiologically examined by independent investigators. For all patients, the long-term Odom score was compared with the score as obtained 6 weeks after surgery. For myelopathic cases, both the late Nurick and the Odom score were compared with the initial postoperative situation. For the adjacent disc levels, a radiologic "degeneration score" was defined and assessed both initially and at long-term follow-up. At late follow-up after anterior cervical interbody fusion, additional radiologic degeneration at the adjacent disc levels was found in 92% of the cases, often reflecting a clinical deterioration. The severity of this additional degeneration correlated with the time interval since surgery. The similarity of progression to degeneration between younger trauma patients and older nontrauma patients suggests that both the biomechanical impact of the interbody fusion and the natural progression of pre-existing degenerative disease act as triggering factors for adjacent level degeneration.