宫颈退行性疾病的手术结果:文献综述。

ISRN orthopedics Pub Date : 2012-01-16 eCollection Date: 2012-01-01 DOI:10.5402/2012/165050
Kazuya Nishizawa, Kanji Mori, Yasuo Saruhashi, Yoshitaka Matsusue
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引用次数: 8

摘要

迄今为止,进行了几项研究,以找出哪种手术优于其他手术治疗颈脊髓病。手术治疗的目的是减压神经,恢复椎体的排列,稳定脊柱。因此,颈椎退行性疾病的治疗可分为单独神经减压、单独颈椎固定或两者结合。后路入路历来被认为是治疗颈椎多节段狭窄和颈椎前凸对准的安全和直接的方法。另一方面,对于颈椎受压、前位因素、相对短节段狭窄和颈椎后凸的患者,建议采用前路入路。近年来,由于各种器械的发展,后路手术被广泛应用于多种颈椎退行性疾病。无论是后路手术还是前路手术,都有各自的并发症。没有一级或二级证据表明椎板成形术优于其他减压技术。然而,III级证据显示椎板成形术、颈椎前路融合术和椎板切除术合并关节融合术在功能改善方面是相同的。现在,每个外科医生倾向于通过评估患者的临床情况来选择每种方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Operative outcomes for cervical degenerative disease: a review of the literature.

To date, several studies were conducted to find which procedure is superior to the others for the treatment of cervical myelopathy. The goal of surgical treatment should be to decompress the nerves, restore the alignment of the vertebrae, and stabilize the spine. Consequently, the treatment of cervical degenerative disease can be divided into decompression of the nerves alone, fixation of the cervical spine alone, or a combination of both. Posterior approaches have historically been considered safe and direct methods for cervical multisegment stenosis and lordotic cervical alignment. On the other hand, anterior approaches are indicated to the patients with cervical compression with anterior factors, relatively short-segment stenosis, and kyphotic cervical alignment. Recently, posterior approach is widely applied to several cervical degenerative diseases due to the development of various instruments. Even if it were posterior approach or anterior approach, each would have its complication. There is no Class I or II evidence to suggest that laminoplasty is superior to other techniques for decompression. However, Class III evidence has shown equivalency in functional improvement between laminoplasty, anterior cervical fusion, and laminectomy with arthrodesis. Nowadays, each surgeon tends to choose each method by evaluating patients' clinical conditions.

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