...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Neurosurgical focus >Multilevel cervical arthroplasty: current evidence. A systematic review
【24h】

Multilevel cervical arthroplasty: current evidence. A systematic review

机译：多级颈椎置换术：最新证据。系统评价

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE Cervical disc arthroplasty (CDA) has been demonstrated to be an effective treatment modality for single-level cervical radiculopathy or myelopathy. Its advantages over an anterior cervical discectomy and fusion (ACDF) include motion preservation and decreased reoperations at the index and adjacent segments up to 7 years postoperatively. Considering the fact that many patients have multilevel cervical disc degeneration (CDD), the authors performed a systematic review of the clinical studies evaluating patients who underwent multilevel CDA (2 or more levels). METHODS A systematic review in the MEDLINE database was performed. Clinical studies including patients who had multilevel CDA were selected and included. Case reports and literature reviews were excluded. Articles were then grouped according to their main study objective: 1) studies comparing multilevel CDA versus ACDF; 2) studies comparing single-level CDA versus multilevel CDA; and 3) multilevel CDA after a previous cervical spine surgery. RESULTS Fourteen articles met all inclusion criteria. The general conclusions were that multilevel CDA was at least as safe and effective as ACDF, with preservation of cervical motion when compared with ACDF and potentially with fewer reoperations expected in most of the studies. Multilevel CDAs are clinically effective as single-level surgeries, with good clinical and radiological outcomes. Some studies reported a higher incidence of heterotopic ossification in multilevel CDA when compared with single-level procedures, but without clinical relevance during the follow-up period. A CDA may be indicated even after a previous cervical surgery in selected cases. CONCLUSIONS The current literature supports the use of multilevel CDA. Caution is necessary regarding the more restrictive indications for CDA when compared with ACDF. Further prospective, controlled, multicenter, and randomized studies not sponsored by the device manufactures are desirable to prove the superiority of CDA surgery over ACDF as the treatment of choice for CDD in selected cases.
机译：目的颈椎间盘置换术（CDA）已被证明是单级颈椎神经根病或脊髓病的一种有效治疗方式。与前颈椎间盘摘除术和融合术（ACDF）相比，它的优势在于可以保持运动，并在术后7年之内在索引部位和邻近部位减少再次手术。考虑到许多患者患有多级颈椎间盘退变（CDD）的事实，作者对评估接受多级CDA（2级或更多级）的患者的临床研究进行了系统评价。方法在MEDLINE数据库中进行了系统评价。选择并纳入包括多级CDA患者在内的临床研究。病例报告和文献复习被排除在外。然后根据文章的主要研究目的将文章分组：1）比较多级CDA与ACDF的研究; 2）比较单级CDA与多级CDA的研究; 3）先前进行过颈椎手术的多级CDA。结果14篇文章符合所有纳入标准。总体结论是，多级CDA至少与ACDF一样安全有效，与ACDF相比可保持子宫颈运动，并且在大多数研究中预计可减少再次手术。多级CDA作为单级手术在临床上是有效的，并具有良好的临床和放射学结果。一些研究报告说，与单级手术相比，多级CDA的异位骨化发生率更高，但在随访期间没有临床意义。在某些情况下，即使在先前的宫颈手术后也可能需要CDA。结论当前文献支持多级CDA的使用。与ACDF相比，必须谨慎对待CDA的限制性更强的适应症。由设备制造商赞助的进一步的前瞻性，对照，多中心和随机研究希望证明CDA手术优于ACDF作为在某些情况下选择CDD的治疗方法。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号