Objective:To investigate a novel surgical method for multilevel cervical spondylotic myeIopa- thy(CSM).Methods:Totally 21 patients with multilevel CSM undergoing a novel surgical procedure from April 2001 to January 2...Objective:To investigate a novel surgical method for multilevel cervical spondylotic myeIopa- thy(CSM).Methods:Totally 21 patients with multilevel CSM undergoing a novel surgical procedure from April 2001 to January 2004 were analyzed retrospectively.All patients experienced anterior cervical decompression surgery in subsection,autograft fusion and internal fixation.Preoperative,immediate post- operative and follow-up image data,X-rays and semi-quantitative Japanese orthopaedics association(JOA) scores were used to evaluate the restoration of lordosis(Cobb's angle),intervertebral heights,the stabili- ty of the cervical spine and the improvement of neurological impairment.Results:Preoperative symptoms were markedly alleviated or disappeared in most of the patients.According to the JOA scores,the ratio of improvement in neurological function was 72.2%,including excellent in 9 cases(42.9%),good in 7 cases (33.30%),fair in 3 cases(14.3%)and poor in 2 cases(9.5%).Immediate postoperative X-rays showed obvious improvements in lordosis and in the intervertebral height of the cervical spine(P<0.01).There is no evidence of instrument failure during the mean follow-up period of 14.2 months(9-24 months, P>0.01).Conclusion:Anterior cervical decompression in subsection,autograft fusion and internal fixa- tion is a rational effective method for the surgical treatment of multilevel CSM.展开更多
BACKGROUND Unilateral exophthalmos is often caused by inflammation, neoplasm, infection,metabolic disease, vascular disorder and several other less common conditions.Reflex sympathetic dystrophy related to unilateral ...BACKGROUND Unilateral exophthalmos is often caused by inflammation, neoplasm, infection,metabolic disease, vascular disorder and several other less common conditions.Reflex sympathetic dystrophy related to unilateral exophthalmos has not been reported in the past literature.CASE SUMMARY We describe a 45-year-old female with unilateral exophthalmos caused by reflex sympathetic dystrophy and its unexpected spontaneous disappearance after a standard anterior cervical discectomy and fixation operation with two PEEK interbody cages and a plate. To our surprise, the patient’s left unilateral exophthalmos improved spontaneously in the morning on postoperative day 2-with no relapse, without any further medication, as of seven years. We have named this condition "cervicogenic exophthalmos."CONCLUSION We would inform other clinicians that unilateral exophthalmos was caused not only by inflammation, vascular disorder, infection, neoplasm, or metabolic disease, but also by reflex sympathetic dystrophy related with cervicogenic spondylosis. To the best of our knowledge, ours is the first related case report and use of the term "cervicogenic exophthalmos" after reviewing previous literature.展开更多
目的:比较前路颈椎间盘切除融合术(anterior cervical discectomy and fusion,ACDF)联合前路椎体次全切钛网植骨融合术(anterior cervical corpectomy and fusion,ACCF)与颈后路单开门微型钛板内固定术治疗3节段脊髓型颈椎病的临床疗效...目的:比较前路颈椎间盘切除融合术(anterior cervical discectomy and fusion,ACDF)联合前路椎体次全切钛网植骨融合术(anterior cervical corpectomy and fusion,ACCF)与颈后路单开门微型钛板内固定术治疗3节段脊髓型颈椎病的临床疗效。方法:对2014年3月至2016年3月手术治疗的63例(男39例,女24例)3节段脊髓型颈椎病患者的临床资料进行回顾性分析,其中43例行ACDF联合ACCF(前路组),20例行颈后路单开门微型钛板内固定术(后路组)。比较两组患者的手术时间、术中出血量、术后并发症发生率,并按照JOA评分标准评定两组患者的临床疗效。结果:所有病例获得随访,时间16~40个月,平均25.8个月。前路组与后路组患者手术时间分别为(123.70±6.21)min和(118.70±5.41)min,差异无统计学意义(P>0.05);术中出血量分别(85.23±7.51)ml和(107.18±9.41)ml,差异有统计学意义(P<0.05)。前路组发生轴性症状6例,吞咽困难1例,未发生C5神经根麻痹、声音嘶哑及呛咳等并发症,并发症发生率为16.3℅(7/43);后路组发生轴性症状5例,C5神经根麻痹1例,未发生吞咽困难、声音嘶哑及呛咳等并发症,并发症发生率为30.0℅(6/20),两组并发症发生率比较差异有统计学意义(P<0.05)。前路组术后1周及末次随访时的JOA评分均优于后路组(P<0.05)。结论 :两种手术方式治疗脊髓型颈椎病均能提供即刻的稳定性,前路联合手术在术中出血量、并发症发生率、临床疗效方面均优于后路组,因此对于连续性3节段脊髓型颈椎病的治疗倾向于前路联合手术。展开更多
文摘Objective:To investigate a novel surgical method for multilevel cervical spondylotic myeIopa- thy(CSM).Methods:Totally 21 patients with multilevel CSM undergoing a novel surgical procedure from April 2001 to January 2004 were analyzed retrospectively.All patients experienced anterior cervical decompression surgery in subsection,autograft fusion and internal fixation.Preoperative,immediate post- operative and follow-up image data,X-rays and semi-quantitative Japanese orthopaedics association(JOA) scores were used to evaluate the restoration of lordosis(Cobb's angle),intervertebral heights,the stabili- ty of the cervical spine and the improvement of neurological impairment.Results:Preoperative symptoms were markedly alleviated or disappeared in most of the patients.According to the JOA scores,the ratio of improvement in neurological function was 72.2%,including excellent in 9 cases(42.9%),good in 7 cases (33.30%),fair in 3 cases(14.3%)and poor in 2 cases(9.5%).Immediate postoperative X-rays showed obvious improvements in lordosis and in the intervertebral height of the cervical spine(P<0.01).There is no evidence of instrument failure during the mean follow-up period of 14.2 months(9-24 months, P>0.01).Conclusion:Anterior cervical decompression in subsection,autograft fusion and internal fixa- tion is a rational effective method for the surgical treatment of multilevel CSM.
文摘BACKGROUND Unilateral exophthalmos is often caused by inflammation, neoplasm, infection,metabolic disease, vascular disorder and several other less common conditions.Reflex sympathetic dystrophy related to unilateral exophthalmos has not been reported in the past literature.CASE SUMMARY We describe a 45-year-old female with unilateral exophthalmos caused by reflex sympathetic dystrophy and its unexpected spontaneous disappearance after a standard anterior cervical discectomy and fixation operation with two PEEK interbody cages and a plate. To our surprise, the patient’s left unilateral exophthalmos improved spontaneously in the morning on postoperative day 2-with no relapse, without any further medication, as of seven years. We have named this condition "cervicogenic exophthalmos."CONCLUSION We would inform other clinicians that unilateral exophthalmos was caused not only by inflammation, vascular disorder, infection, neoplasm, or metabolic disease, but also by reflex sympathetic dystrophy related with cervicogenic spondylosis. To the best of our knowledge, ours is the first related case report and use of the term "cervicogenic exophthalmos" after reviewing previous literature.
文摘目的:比较前路颈椎间盘切除融合术(anterior cervical discectomy and fusion,ACDF)联合前路椎体次全切钛网植骨融合术(anterior cervical corpectomy and fusion,ACCF)与颈后路单开门微型钛板内固定术治疗3节段脊髓型颈椎病的临床疗效。方法:对2014年3月至2016年3月手术治疗的63例(男39例,女24例)3节段脊髓型颈椎病患者的临床资料进行回顾性分析,其中43例行ACDF联合ACCF(前路组),20例行颈后路单开门微型钛板内固定术(后路组)。比较两组患者的手术时间、术中出血量、术后并发症发生率,并按照JOA评分标准评定两组患者的临床疗效。结果:所有病例获得随访,时间16~40个月,平均25.8个月。前路组与后路组患者手术时间分别为(123.70±6.21)min和(118.70±5.41)min,差异无统计学意义(P>0.05);术中出血量分别(85.23±7.51)ml和(107.18±9.41)ml,差异有统计学意义(P<0.05)。前路组发生轴性症状6例,吞咽困难1例,未发生C5神经根麻痹、声音嘶哑及呛咳等并发症,并发症发生率为16.3℅(7/43);后路组发生轴性症状5例,C5神经根麻痹1例,未发生吞咽困难、声音嘶哑及呛咳等并发症,并发症发生率为30.0℅(6/20),两组并发症发生率比较差异有统计学意义(P<0.05)。前路组术后1周及末次随访时的JOA评分均优于后路组(P<0.05)。结论 :两种手术方式治疗脊髓型颈椎病均能提供即刻的稳定性,前路联合手术在术中出血量、并发症发生率、临床疗效方面均优于后路组,因此对于连续性3节段脊髓型颈椎病的治疗倾向于前路联合手术。
