Anterior Segmental Decompression and Interbody Fusion for Multi-segmental Cervical Spondylotic Myelopathy in the Elderly
Journal of Surgery
Volume 5, Issue 4, August 2017, Pages: 58-61
Received: May 25, 2017; Accepted: Jun. 5, 2017; Published: Jul. 21, 2017
Views 1592      Downloads 74
Authors
Guowei Zhang, Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Zhengbin Cai, Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Qiuling Liu, Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Zhisheng Ji, Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Yuhao Yang, Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Hongsheng Lin, Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China
Article Tools
Follow on us
Abstract
To explore the clinical effect of anterior segmental decompression and interbody fusion in treatment of elderly patients with complex cervical spondylotic myelopathy of three segments or more, 50 patients, with titanium plate internal fixation bone fusion underwent anterior cervical decompression and multi segmental cervical spondylosis, were collected. Parameters of operation time, intraoperative blood loss, JOA score 1 week before and after, 12 months after operation, cervical X-ray, CT and MRI before and after operation were measured. Clinical symptoms and the improvement of JOA, internal fixation and bone grafting fusion, cervical standard sagittal Cobb angle, lateral fusion segment of vertebral body height (height of anterior border, HAB) and posterior height (height of posterior border, HPB), were observed. Operation time was 90 ~ 150 minutes, average 120 minutes. The amount of bleeding 150 ~ 450 ml, average 325.5 ml. Mean follow-up time was 15.1 months. 2 weeks after operation, sympathetic symptoms were improved obviously, lower limb muscle strength was increased, physical activity was significantly improved, and anesthesia of double upper limbs disappeared. Except for the 3 cases who had serious cervical spinal cord injury showed no obvious recovery, the other 47 patients showed significant improved neurological recovery. X-ray results of 12 months after operation showed that 50 cases of fused intervertebral, intervertebral height and lordosis maintained good. In general, anterior segmental decompression and bone graft fusion and titanium plate internal fixation operation is a safe and effective operation for treating the three section and above cervical spondylotic myelopathy, worth recommending.
Keywords
Cervical Spondylosis, Segmental Decompression, Bone Graft, Fusion
To cite this article
Guowei Zhang, Zhengbin Cai, Qiuling Liu, Zhisheng Ji, Yuhao Yang, Hongsheng Lin, Anterior Segmental Decompression and Interbody Fusion for Multi-segmental Cervical Spondylotic Myelopathy in the Elderly, Journal of Surgery. Vol. 5, No. 4, 2017, pp. 58-61. doi: 10.11648/j.js.20170504.11
Copyright
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Gok, B., D. M. Sciubba, G. S. McLoughlin, M. McGirt, S. Ayhan, J. P. Wolinsky, A. Bydon, Z. L. Gokaslan, and T. F. Witham, Surgical treatment of cervical spondylotic myelopathy with anterior compression: a review of 67 cases. J Neurosurg Spine, 2008, 9 (2): 152-7.
[2]
Hirai, T., S. Kawabata, M. Enomoto, T. Kato, S. Tomizawa, K. Sakai, T. Yoshii, K. Sakaki, K. Shinomiya, and A. Okawa, Presence of anterior compression of the spinal cord after laminoplasty inhibits upper extremity motor recovery in patients with cervical spondylotic myelopathy. Spine (Phila Pa 1976), 2012, 37 (5): 377-84.
[3]
Li, Y., H. Wang, Y. Wang, and H. Liu, [Effect of Anterior Cervical Spinal Cord Compression Factor in Treatment of Cervical Spondylotic Myelopathy]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi, 2015, 29(9): 1099-103.
[4]
Cho, Y., The Change of Range of Motion at Anterior Compression of the Cervical Cord after Laminoplasty in Patients with Cervical Spondylotic Myelopathy. Korean J Spine, 2016, 13(4): 177-182.
[5]
Zhou, X., P. Cai, Y. Li, H. Wang, S. Xia, and X. Wang, Posterior or Single-stage Combined Anterior and Posterior Approach Decompression for Treating Complex Cervical Spondylotic Myelopathy Coincident Multilevel Anterior and Posterior Compression. Clin Spine Surg, 2016.
[6]
Hirai, T., T. Yoshii, Y. Arai, K. Sakai, I. Torigoe, H. Maehara, M. Tomori, T. Taniyama, H. Sato, and A. Okawa, A Comparative Study of Anterior Decompression With Fusion and Posterior Decompression With Laminoplasty for the Treatment of Cervical Spondylotic Myelopathy Patients With Large Anterior Compression of the Spinal Cord. Clin Spine Surg, 2017.
[7]
Singh, K., A. R. Vaccaro, J. Kim, E. P. Lorenz, T. H. Lim, and H. S. An, Enhancement of stability following anterior cervical corpectomy: a biomechanical study. Spine (Phila Pa 1976), 2004, 29 (8): 845-9.
[8]
Suzuki, A., K. Tamai, H. Terai, M. Hoshino, H. Toyoda, S. Takahashi, K. Hayashi, S. Ohyama, and H. Nakamura, Clinical Outcome of Cervical Laminoplasty and Postoperative Radiological Change for Cervical Myelopathy With Degenerative Spondylolisthesis. Spine (Phila Pa 1976), 2016, 41 (23): 1808-1812.
[9]
Dean, C. L., J. P. Gabriel, E. H. Cassinelli, M. J. Bolesta, and H. H. Bohlman, Degenerative spondylolisthesis of the cervical spine: analysis of 58 patients treated with anterior cervical decompression and fusion. Spine J, 2009, 9 (6): 439-46.
[10]
Kim, H. C., H. S. Jun, J. H. Kim, I. B. Chang, J. H. Song, and J. K. Oh, The Effect of the Pedicle-Facet Angle on Degenerative Cervical Spondylolisthesis. J Korean Neurosurg Soc, 2015, 58 (4): 341-5.
[11]
Suzuki, A., M. D. Daubs, H. Inoue, T. Hayashi, B. Aghdasi, S. R. Montgomery, M. Ruangchainikom, X. Hu, C. J. Lee, C. J. Wang, B. J. Wang, and H. Nakamura, Prevalence and motion characteristics of degenerative cervical spondylolisthesis in the symptomatic adult. Spine (Phila Pa 1976), 2013, 38 (17): E1115-20.
[12]
Park, M. S., S. H. Moon, H. M. Lee, S. W. Kim, T. H. Kim, B. K. Suh, and K. D. Riew, The natural history of degenerative spondylolisthesis of the cervical spine with 2- to 7-year follow-up. Spine (Phila Pa 1976), 2013, 38 (4): E205-10.
[13]
Ashkenazi, E., Y. Smorgick, N. Rand, M. A. Millgram, Y. Mirovsky, and Y. Floman, Anterior decompression combined with corpectomies and discectomies in the management of multilevel cervical myelopathy: a hybrid decompression and fixation technique. J Neurosurg Spine, 2005, 3 (3): 205-9.
[14]
Liu, J. M., X. Xiong, A. F. Peng, M. Xu, X. Y. Chen, X. H. Long, R. Xu, and Z. L. Liu, A comparison of local bone graft with PEEK cage versus iliac bone graft used in anterior cervical discectomy and fusion. Clin Neurol Neurosurg, 2017, 155: 30-35.
[15]
Yson, S. C., J. N. Sembrano, and E. R. Santos, Comparison of allograft and polyetheretherketone (PEEK) cage subsidence rates in anterior cervical discectomy and fusion (ACDF). J Clin Neurosci, 2017, 38: 118-121.
[16]
Farrokhi, M. R., Z. Nikoo, M. Gholami, and K. Hosseini, Comparison Between Acrylic Cage and Polyetheretherketone (PEEK) Cage in Single-level Anterior Cervical Discectomy and Fusion: A Randomized Clinical Trial. Clin Spine Surg, 2017, 30 (1): 38-46.
[17]
Farrokhi, M. R., Z. Nikoo, M. Gholami, and K. Hosseini, Comparison between Acrylic Cage and Polyetheretherketone (PEEK) Cage in Single-Level Anterior Cervical Discectomy and Fusion: A Randomized Clinical Trial. Clin Spine Surg, 2016.
[18]
Chen, Y., G. Lu, B. Wang, L. Li, and L. Kuang, A comparison of anterior cervical discectomy and fusion (ACDF) using self-locking stand-alone polyetheretherketone (PEEK) cage with ACDF using cage and plate in the treatment of three-level cervical degenerative spondylopathy: a retrospective study with 2-year follow-up. Eur Spine J, 2016, 25 (7): 2255-62. a.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186