Prioritized cervical or lumbar surgical procedure for coexisting cervical and lumbar stenosis: Prognostic evaluation of 222 case.
Int J Surg. 2017 Aug;44:344-349
Authors: Li H, Chen Z, Li X, Liu T, Shen B, Huang Y, Wu D
BACKGROUND CONTEXT: Single-stage surgical procedure is often utilized to enhancing the signs of coexisting cervical and lumbar stenosis. Normally, sufferers’ willingness, surgical procedure affordability, surgical trauma, surgical issues and sufferers’ tolerance to surgical procedure all restrict the appliance of single-stage surgical procedure. For sufferers who can’t obtain single-stage surgical procedure, we hope that we will discover out by weighing up deserves and flaws of the 2 surgical websites as a way to make choice of prioritize one of many two surgical procedure, in order to convey extra advantages to the sufferers.
OBJECTIVE: To verify which one in all prioritized cervical surgical procedure and prioritized lumbar surgical procedure has a greater impact in assuaging the signs of sufferers with coexisting cervical and lumbar stenosis.
STUDY DESIGN: A retrospective evaluation and a cohort research for 15 years.
PATIENT SAMPLE: The knowledge of 222 sufferers who had been recognized with coexisting cervical and lumbar stenosis over the previous 15 years was collected, together with 144 sufferers who underwent prioritized cervical surgical procedure and 78 prioritized lumbar surgical procedure, thereafter the modifications within the sufferers’ postoperative neurological capabilities had been evaluated.
OUTCOME MEASURES: Major consequence variables are the scientific analysis occasion and the occasion of surgical website positioning. Secondary variables are the occasion of postoperative perform modifications and the symptom enchancment occasion.
METHODS: The details about 222 sufferers with coexisting cervical and lumbar stenosis who had a follow-up of greater than 1 12 months throughout January 2000 and December 2014 was collected. The consequences of prioritized staged cervical and lumbar surgical procedures on the prognosis for the above-mentioned sufferers had been respectively evaluated through related analysis indexes.
RESULTS: The follow-up time was 18-156 months (58.zero ± 36.5). The lumbar reoperation charge after prioritized cervical surgical procedure was decrease than the cervical reoperation charge after prioritized lumbar surgical procedure (22.91% < 57.69%) (P < zero.01). The JOA rating and Nurick grade considerably improved (P < zero.01) and the ODI rating improved (P < zero.05) after prioritized cervical surgical procedure. No apparent enchancment within the JOA rating and Nurick grade (P > zero.05) was proven however the ODI rating markedly improved (P < zero.01) after prioritized lumbar surgical procedure.
CONCLUSIONS: For sufferers with coexisting cervical and lumbar stenosis, prioritized cervical surgical procedure is secure and efficient and is superior to prioritized lumbar surgical procedure on the advance of cervical and lumbar signs, the postoperative restoration of limb perform and the speed of reoperation on one other website.
PMID: 28711623 [PubMed – indexed for MEDLINE]