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[Anterior cervical hybrid surgical treatment for multilevel cervical spondylotic myelopathy].
Zhongguo Gu Shang. 2017 Sep 25;30(9):838-843
Authors: Zhan BS, Jiang XS, Zhou GS, Ji YF
Summary
OBJECTIVE: To judge the medical outcomes of anterior cervical discectomy and reconstruction with a self-locking cage and inner fixation with brief segmental plate for multilevel cervical spondylotic myelopathy.
METHODS: From January 2012 to June 2015, a complete of 106 sufferers acquired anterior cervical discectomy and reconstruction with a self-locking cage and inner fixation with brief segmental plate have been adopted up. There have been 71 males and 35 females, aged from 42 to 74 years outdated with a mean of(55.four±5.1) years. Three segments have been concerned in 82 circumstances and 4 segments in 24 circumstances. Operation time, blood loss, postoperative drainage, and hospitalization time have been recorded. Visible analogue scale(VAS) and Japanese Orthopaedic Affiliation Rating (JOA) have been analyzed earlier than and after operation(together with 5 days, three, 6, 12 months after operation and remaining follow-up), and the JOA enchancment charge was analyzed. The cervical lordosis and ROM have been measured earlier than and after operation(together with the follow-up level above) by X-rays. The postoperative problems have been recorded and analyzed as nicely.
RESULTS: All of the operations have been profitable. The typical operative time was (126.2±25.1) min, and the quantity of blood loss was (82.1±26.three) ml. All of the sufferers have been adopted up from 12 to 48 months with a mean of (30.four±10.5) months. The VAS rating of neck ache and JOA rating was considerably higher from 6.11±1.54 and 9.22±2.42 preoperatively to 2.14±zero.51 and 12.46±1.42 at 5 days post-operation, respectively(P<zero.05). The advance charge of JOA was (56.7±21.6)%, there was no statistically important distinction of VAS, JOA scores and the advance charge of JOA at every time after operation (P>zero.05). Postoperative cervical lordosis at three months was considerably improved from preoperative (11.5±6.eight)° to (19.6±eight.9)°(P<zero.05), and it could actually preserve passable stability till remaining follow-up(P>zero.05). Postoperative ROM at three months was considerably decreased from the preoperative (37.6±10.four)° to (18.2±5.9)°(P<zero.05), however there was no important change within the strategy of follow-up (P>zero.05). All of the problems corresponding to dysphagia (19 circumstances), axial neck ache(6 circumstances), cerebral fluid leakage(three circumstances), and hoarseness(2 circumstances), obtained higher after conservative remedy. Three circumstances had intervertebral house non-fusion till remaining follow-up(with out medical symptom), however no loosening, breakage, or displacement of inner fixation have been discovered.
CONCLUSIONS: Anterior cervical discectomy, reconstruction with a self-locking cage and inner fixation with brief segmental plate which may cut back intraoperative damage, restore cervical lordosis, enhance neurological perform and decrease postoperative problems, it’s another remedy for multilevel cervical spondylotic myelopathy.
PMID: 29455486 [PubMed – in process]