{"title":"前路颈椎椎间盘切除术和融合术治疗钳形颈椎病:一项单中心回顾性研究。","authors":"Xinyu Zhang, Baogan Peng, Zengbiao Ma, Bing Wu, Chunyu Liu, Yongchao Li","doi":"10.1016/j.wneu.2024.09.041","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Anterior and posterior compression of the cervical spinal cord is usually called pincer cervical spondylotic myelopathy (p-CSM), and surgery is generally recommended; however, there is some controversy about the choice of surgical approach because single anterior or posterior surgery cannot effectively relieve contralateral compression, and combined surgery may cause problems related to trauma and effects on cervical spine function.</p><p><strong>Objective: </strong>To investigate the feasibility and indications of single anterior cervical discectomy and fusion (ACDF) for the treatment of p-CSM.</p><p><strong>Methods: </strong>The data of 21 p-CSM patients who were treated with ACDF at a single center from 2019 to 2022 were collected. Neurologic status was evaluated by the Japanese Orthopedic Association scoring system. The radiologic parameters included the percentage of space occupied by the spinal canal, the cervical sagittal Cobb angle, and the cross-sectional area of the spinal cord before and after the operation. Complications and spinal cord compression rates were also observed. Correlations between the decompressive effects and various prognostic factors were statistically analyzed.</p><p><strong>Results: </strong>The mean follow-up period was 24.1 ± 3.55 months. The average Japanese Orthopedic Association score significantly increased, with a mean recovery rate of 65.88 ± 8.97%. The fusion rate was satisfactory. Correlation analysis revealed that the number of operation segments and age were important predictors of decompressive effects. There was no further deterioration of spinal cord function after the operation.</p><p><strong>Conclusions: </strong>ACDF is an effective method for treating pincer spinal cord compression in terms of neurologic recovery, radiologic parameters, fusion rates, and complications, especially for patients younger than 60 years of age with single operative segments.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"e772-e778"},"PeriodicalIF":1.9000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Anterior Cervical Discectomy and Fusion for the Treatment of Pincer Cervical Spondylotic Myelopathy: A Single-Center Retrospective Study.\",\"authors\":\"Xinyu Zhang, Baogan Peng, Zengbiao Ma, Bing Wu, Chunyu Liu, Yongchao Li\",\"doi\":\"10.1016/j.wneu.2024.09.041\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Anterior and posterior compression of the cervical spinal cord is usually called pincer cervical spondylotic myelopathy (p-CSM), and surgery is generally recommended; however, there is some controversy about the choice of surgical approach because single anterior or posterior surgery cannot effectively relieve contralateral compression, and combined surgery may cause problems related to trauma and effects on cervical spine function.</p><p><strong>Objective: </strong>To investigate the feasibility and indications of single anterior cervical discectomy and fusion (ACDF) for the treatment of p-CSM.</p><p><strong>Methods: </strong>The data of 21 p-CSM patients who were treated with ACDF at a single center from 2019 to 2022 were collected. Neurologic status was evaluated by the Japanese Orthopedic Association scoring system. The radiologic parameters included the percentage of space occupied by the spinal canal, the cervical sagittal Cobb angle, and the cross-sectional area of the spinal cord before and after the operation. Complications and spinal cord compression rates were also observed. Correlations between the decompressive effects and various prognostic factors were statistically analyzed.</p><p><strong>Results: </strong>The mean follow-up period was 24.1 ± 3.55 months. The average Japanese Orthopedic Association score significantly increased, with a mean recovery rate of 65.88 ± 8.97%. The fusion rate was satisfactory. Correlation analysis revealed that the number of operation segments and age were important predictors of decompressive effects. There was no further deterioration of spinal cord function after the operation.</p><p><strong>Conclusions: </strong>ACDF is an effective method for treating pincer spinal cord compression in terms of neurologic recovery, radiologic parameters, fusion rates, and complications, especially for patients younger than 60 years of age with single operative segments.</p>\",\"PeriodicalId\":23906,\"journal\":{\"name\":\"World neurosurgery\",\"volume\":\" \",\"pages\":\"e772-e778\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.wneu.2024.09.041\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2024.09.041","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/12 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Anterior Cervical Discectomy and Fusion for the Treatment of Pincer Cervical Spondylotic Myelopathy: A Single-Center Retrospective Study.
Background: Anterior and posterior compression of the cervical spinal cord is usually called pincer cervical spondylotic myelopathy (p-CSM), and surgery is generally recommended; however, there is some controversy about the choice of surgical approach because single anterior or posterior surgery cannot effectively relieve contralateral compression, and combined surgery may cause problems related to trauma and effects on cervical spine function.
Objective: To investigate the feasibility and indications of single anterior cervical discectomy and fusion (ACDF) for the treatment of p-CSM.
Methods: The data of 21 p-CSM patients who were treated with ACDF at a single center from 2019 to 2022 were collected. Neurologic status was evaluated by the Japanese Orthopedic Association scoring system. The radiologic parameters included the percentage of space occupied by the spinal canal, the cervical sagittal Cobb angle, and the cross-sectional area of the spinal cord before and after the operation. Complications and spinal cord compression rates were also observed. Correlations between the decompressive effects and various prognostic factors were statistically analyzed.
Results: The mean follow-up period was 24.1 ± 3.55 months. The average Japanese Orthopedic Association score significantly increased, with a mean recovery rate of 65.88 ± 8.97%. The fusion rate was satisfactory. Correlation analysis revealed that the number of operation segments and age were important predictors of decompressive effects. There was no further deterioration of spinal cord function after the operation.
Conclusions: ACDF is an effective method for treating pincer spinal cord compression in terms of neurologic recovery, radiologic parameters, fusion rates, and complications, especially for patients younger than 60 years of age with single operative segments.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS