Cervical arthroplasty in the management of spondylotic myelopathy
Cervical arthroplasty in the management of spondylotic myelopathy
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DOI：
10.1097/00024720-200308000-00001
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发表时间：
2003-08-01
影响因子：
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通讯作者：
Sekhon, LHS
中科院分区：
文献类型：
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作者：
Sekhon, LHS
通过前路关节融合术治疗颈脊髓压迫与活动度降低和邻近节段退变加速相关。人工颈椎间盘置换术可以解决这些问题。一系列的7例（3名女性，2名男性;年龄31-55岁）颈椎前路减压和人工椎间盘假体的放置。总共9个Bryan颈椎间盘假体（Spinal Dynamics Corp.，美世岛，华盛顿州）被放置。在24小时、6周、3个月、6个月和之后每年进行临床和影像学随访（平均随访期6.29个月，范围1-17个月）。无并发症。Nurick分级改善0.72级（P < 0.05），奥斯韦斯特里颈部功能障碍指数评分改善51.4分（P < 0.0001）。运动被保留了下来。29%的病例脊柱前凸改善。术后影像学检查脊髓减压。在一个或多个节段的颈椎前路减压后进行颈椎关节成形术是治疗继发于脊柱疾病或急性椎间盘突出的脊髓压迫的一种令人兴奋的工具。这是第一项专门针对颈椎成形术治疗颈椎脊髓病的研究。长期随访将揭示人工椎间盘植入术的任何延迟问题，但在短期内，这项技术提供了一个很好的结果。
Cervical spinal cord compression managed via an anterior approach with an arthrodesis is associated with a decreased range of motion and accelerated adjacent segment degeneration. Artificial cervical disc replacement may address these problems. A series of seven cases (three women, two men; age 31-55 years) of anterior cervical decompression and placement of an artificial disc prosthesis is presented. A total of nine Bryan cervical disc prostheses (Spinal Dynamics Corp., Mercer Island, WA) were placed. Clinical and radiologic follow-up was performed at 24 hours, 6 weeks, 3 months, 6 months, and then yearly (mean follow-up period 6.29 months, range 1-17 months). There were no complications. There was an improvement in Nurick grade by 0.72 grade (P < 0.05) and Oswestry Neck Disability Index score by 51.4 points (P < 0.0001). Motion was preserved. Improvement in lordosis occurred in 29% of cases. The spinal cord was decompressed on postoperative imaging. Cervical arthroplasty after anterior cervical decompression at one or more levels represents an exciting tool in the management of spinal cord compression secondary to spondylotic disease or acute disc prolapse. This is the first study that looks specifically at cervical arthroplasty for cervical myelopathy. Longer follow-up will reveal any delayed problems with artificial disc implantation, but in the short term, this technique offers an excellent outcome.