当前位置： SCI文献检索 > SPINE期刊下所有文献 > Comparison of Three Reconstructive Techniques in the Surgical Management of Patients With Four-Level Cervical Spondylotic Myelopathy.

Comparison of Three Reconstructive Techniques in the Surgical Management of Patients With Four-Level Cervical Spondylotic Myelopathy.

Abstract：

STUDY DESIGN:Retrospective clinical series. OBJECTIVE:To compare perioperative parameters, clinical outcomes, radiographic parameters, and complication rates of three reconstructive techniques after the anterior decompression of four-level cervical spondylotic myelopathy (CSM). SUMMARY OF BACKGROUND DATA:At present, the decision to treat multilevel CSM, especially four-level CSM, remains controversial. No one compares multilevel anterior cervical discectomy and fusion (mACDF), segmental anterior cervical corpectomy and fusion (sACCF) to multilevel anterior cervical discectomy and fusion with cage alone (mACDF-CA) in four-level constructs. METHODS:Between July 2006 and February 2014, 97 consecutive patients with four-level CSM were enrolled in this study and divided into sACCF (n = 39) group, mACDF (n = 31) group, and mACDF-CA (n = 27) group. The study compared perioperative parameters, complication rates, clinical and radiologic parameters of three reconstructive techniques after the anterior decompression of four-level CSM. RESULTS:The mACDF-CA group had the least bleeding and cost of index surgery compared with the sACCF group having the most bleeding and cost. Although significant pain relief and functional activity improvement have been achieved in the three groups at the final follow-up, there was no significant difference in the Japanese Orthopedic Association, SF-36 and NDI scores among the three groups (P >0.05). The mACDF group maintained the best cervical lordosis at the final follow-up, compared with the sACCF group maintained the worst cervical lordosis. Solid fusion was achieved in 87.1% of subjects in sACCF group, 90.3% in mACDF, and in 88.9% in mACDF-CA. The mACDF-CA group had a higher rate of subsidence and lower rate of dysphagia than other two groups. CONCLUSION:mACDF-CA can be considered an effective and safe alternative procedure in the treatment of the four-level CSM. LEVEL OF EVIDENCE:4.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Li Z,Wang H,Tang J,Ren D,Li L,Hou S,Zhang H,Hou T

doi

10.1097/BRS.0000000000001907

subject

Has Abstract

pub_date

2017-05-15 00:00:00

pages

E575-E583

issue

eissn

0362-2436

issn

1528-1159

pii

00007632-201705150-00004

journal_volume

pub_type

杂志文章

在线工具

Comparison of Three Reconstructive Techniques in the Surgical Management of Patients With Four-Level Cervical Spondylotic Myelopathy.