Ventral correction of postsurgical cervical kyphosis
Ventral correction of postsurgical cervical kyphosis
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DOI：
10.3171/spi.2003.98.1.0001
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发表时间：
2003-01-01
影响因子：
4.1
通讯作者：
Benzel, EC
中科院分区：
文献类型：
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作者：
Steinmetz, MP;Kager, CD;Benzel, EC
Object.颈椎后凸变形可能发生在涉及腹侧或背侧入路的手术后。无论原因如何，如果可能的话，应避免颈椎后凸畸形的发展，如果存在，应在适当的时候进行矫正。作者描述了他们的经验与腹侧矫正技术的医源性（术后）颈椎后凸。对经腹入路矫正术后医源性颈椎后凸畸形的病例进行了回顾性分析。作者采用腹侧入路进行脊柱后凸矫正。手术需要特定的股骨头定位（伸展）、会聚牵引销和腹侧放置的植入物（适当时轴向动态），多点固定，包括至少一个中间固定点。在近14个月的时间里，12例患者符合纳入标准。10例患者接受了至少6个月的随访。他们组成了研究人群。大多数患者出现机械性颈部疼痛作为其症状特征的一部分。畸形矫正的平均幅度（术前至术后）为20度脊柱前凸。术后平均矢状角为6 °。随访期间矢状角的平均变化为2.2度脊柱前凸。采用腹侧入路矫正颈椎畸形，除1例患者外，其他所有患者均实现了脊柱前凸。在随访期间有效地保持了这种姿势。所有患者术后均有所改善; 3例患者术前症状完全缓解。当症状与术后脊柱后凸有关时，应考虑畸形矫正。在大多数情况下，这种手术可以通过腹侧入路有效地进行。
Object. Cervical kyphotic deformation may develop after surgery involving either the ventral or dorsal approach. Regardless of the cause, the development of a cervical kyphotic deformity should be avoided, if possible, and corrected if present, when appropriate. The authors describe their experience with a technique for the ventral correction of iatrogenic (postoperative) cervical kyphosis.Methods. A retrospective review of cases involving correction of postoperative iatrogenic cervical kyphosis via an ventral approach was performed. The authors conducted an ventral approach to kyphosis correction. The procedure required specific head positioning (in extension), convergent distraction pins, and an ventrally placed implant (axially dynamic when appropriate) with multiple points of fixation including at least one point of intermediate fixation. The pre- and postoperative sagittal angle and clinical status were evaluated.During a nearly 14-month period, 12 patients met the inclusion criteria. Ten patients underwent a minimum of 6 months of follow up. They comprised the study population. Most patients presented with mechanical neck pain as part of their symptom profile. The mean magnitude of deformity correction (pre- to postoperative) was 20degrees of lordosis. The mean postoperative sagittal angle was 6degrees of lordosis. The mean change in the sagittal angle during the follow-up period was 2.2degrees of lordosis.Conclusions. The ventral approach to correction of cervical deformity led to the achievement of lordosis in all but one patient. This posture was effectively maintained during the follow-up period. All patients exhibited improvement postoperatively; three experienced complete resolution of their preoperative symptoms. When symptoms are related to postsurgical kyphosis, deformity correction should be considered. Such a procedure may be performed effectively via an ventral approach in most circumstances.