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首页> 外文期刊>Neurosurgery >Multisegmental cervical spondylotic myelopathy and radiculopathy treated by multilevel oblique corpectomies without fusion.
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Multisegmental cervical spondylotic myelopathy and radiculopathy treated by multilevel oblique corpectomies without fusion.

机译：多段斜切开术治疗不合并融合的多节段性颈椎病和神经根病。

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OBJECTIVE: The description of the technique of multilevel oblique corpectomy (MOC) without fusion in the treatment of spondylotic myelopathy and radiculopathy and the analysis of the results of this technique from a series of 101 cases are presented. METHODS: MOC is performed using an anterolateral approach with control of the vertebral artery. The vertebral bodies are drilled obliquely from the lateral side toward the opposite posterolateral corner. More than half of the vertebral bodies are preserved, and no fusion procedure is required. The series of patients from 1992 through 1997 included 54 men and 47 women, with an average age of 57.9 years, who presented with myelopathy (n = 66) or radiculopathy (n = 35). MOC was realized on one to five levels from C2-C3 to C7-T1. Follow-up data were obtained by performing dynamic roentgenography, computed tomography, and magnetic resonance imaging 2 months, 1 year, and 3 years after surgery. RESULTS: The results (Japanese Orthopedic Association score) were improvement in 82% of the patients, worsening in 8%, and stabilization in 10%. Better results were observed in younger patients (<50 yr). No relation between results and duration of symptoms or number of levels could be established. One death occurred as a result of multiorgan failure. No late deterioration was observed; however, three patients with particular features showed delayed instability requiring fusion. CONCLUSION: MOC is a safe and efficient technique. It must be applied for patients with anterior compression and straight or kyphotic axis of the spine. No fusion is required regardless of the number of levels, providing there are no soft discs and there is no preoperative instability.
机译：目的：介绍不合并融合的多级斜行椎体切除术（MOC）治疗脊椎脊髓病和神经根病的方法，并分析该技术在一系列101例病例中的效果。方法：MOC使用前外侧入路控制椎动脉进行。椎体从外侧向相对的后外侧角倾斜地钻出。保留了一半以上的椎体，不需要融合程序。从1992年至1997年的一系列患者包括54例男性和47例女性，平均年龄为57.9岁，患有脊髓病（n = 66）或神经根病（n = 35）。从C2-C3到C7-T1，MOC实现了1-5个级别。术后2个月，1年和3年进行动态X线断层扫描，计算机断层扫描和磁共振成像获得随访数据。结果：结果（日本骨科协会评分）改善了82％，恶化了8％，稳定了10％。在年轻患者（<50岁）中观察到更好的结果。结果与症状持续时间或水平数之间没有关系。多器官功能衰竭导致1人死亡。没有观察到后期恶化;然而，三名具有特定特征的患者表现出不稳定性的延迟，需要融合。结论：MOC是一种安全有效的技术。它必须适用于前路受压且脊柱笔直或后凸轴的患者。不论级别多少，都不需要融合，前提是没有软盘且没有术前不稳定。

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