Abstract:
OBJECTIVE:Whether and when cervical disc arthroplasty (CDA) could be indicated for preoperative cervical spine kyphosis is unclear. The purpose of the study was to compare the clinical and radiological outcomes of single-level CDA and single-level anterior cervical discectomy and fusion (ACDF) in the patient with preoperative reversible kyphosis. PATIENTS AND METHODS:From 2014-2018, patients who underwent single-level CDA and single-level ACDF were consecutively reviewed. The Japanese Orthopedic Association score, Neck Disability Index and VAS were used to evaluate clinical outcomes. Range of motion (ROM), C2-7 Cobb angle, functional spinal unit (FSU) angle, and heterotopic ossification (HO) were assessed. RESULTS:Thirty-eight CDA patients (a mean follow-up of 39.8 months) and 42 ACDF patients (37.6 months) with preoperative reversible kyphosis were included. Both groups had significant improvements in clinical outcomes, without statistically significant differences. Before surgery, there was no significant difference in cervical alignment and ROM between groups. After surgery, both groups had a significant increase in C2-7 angle and FSU without significant inter-group differences. At the last follow-up, CDA group consisted of 5 cases of lordosis, 11 cases of kyphosis and 22 cases of straight spine, while the corresponding case number in ACDF group was 4, 12 and 26 (P = 0.866). The C2-7 ROM was preserved in both groups. The segmental ROM of CDA group decreased mildly from 8.3° preoperatively to 5.1° finally, whereas the segmental ROM of ACDF group decreased significantly to nearly zero. 60.5 % (23/38) patients in CDA group developed HO with 9 levels of grade Ⅲ and 3 levels of grade Ⅳ. CONCLUSION:For the patients with single-level disc degenerative disease and preoperative reversible kyphosis, both CDA and ACDF achieved satisfactory and comparable clinical results. CDA was non-inferior to ACDF regarding the radiological outcomes of cervical alignment. Patients in CDA group had a relatively high incidence of HO formation.
journal_name
Clin Neurol Neurosurgjournal_title
Clinical neurology and neurosurgeryauthors
Hu X,Liu H,Wang B,Hong Y,Rong X,Pu D,Huang Kdoi
10.1016/j.clineuro.2021.106493subject
Has Abstractpub_date
2021-01-18 00:00:00pages
106493eissn
0303-8467issn
1872-6968pii
S0303-8467(21)00020-2journal_volume
202pub_type
杂志文章abstract::Ependymomas account for 3-9% of all neuroepithelial tumors. A peculiar variant of ependymoma known as "giant cell ependymoma" ("GCE") is especially rarely reported, it may pose some difficulties for the diagnosing neuropathologist. Here we present a case of a giant cell ependymoma occuring in a 17-year-old patient wit...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2007.09.018
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journal_title:Clinical neurology and neurosurgery
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journal_title:Clinical neurology and neurosurgery
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2011.09.010
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journal_title:Clinical neurology and neurosurgery
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2016.07.030
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2018.08.020
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.105732
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journal_title:Clinical neurology and neurosurgery
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(93)90029-g
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(97)00026-7
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.clineuro.2004.11.024
更新日期:2006-02-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2008.12.001
更新日期:2009-06-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(02)00088-4
更新日期:2002-12-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2013.01.023
更新日期:2013-08-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2019.04.025
更新日期:2019-07-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(87)80026-4
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(93)90096-y
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
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journal_title:Clinical neurology and neurosurgery
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journal_title:Clinical neurology and neurosurgery
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journal_title:Clinical neurology and neurosurgery
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2006.03.005
更新日期:2006-12-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2004.09.019
更新日期:2005-08-01 00:00:00
abstract::Eighty three chronic subdural hematomas, obtained by surgery or by necropsy, were examinated. The patient age distribution curve of the non-complicated operative cases showed the highest incidence in the first year of life and also a moderate increase in the elderly group. Recurrent hemorrhage in the walls and in the ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(76)80051-0
更新日期:1976-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(96)00009-1
更新日期:1996-05-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2007.08.025
更新日期:2008-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(90)90056-b
更新日期:1990-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.clineuro.2018.06.042
更新日期:2018-09-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2019.105548
更新日期:2019-12-01 00:00:00