北京大学学报（医学版）2018，Vol.50Issue(2)：347-351,5.DOI:10.3969/j.issn.1671-167X.2018.02.024
前路椎间盘切除椎间融合术治疗伴有交感神经症状的颈椎病
Anterior cervical discectomy and fusion to treat cervical spondylosis with sympathetic symptoms
刘洪 1于峥嵘 1孙浩林 1王诗军 1赵耀 1漆龙涛 1王瑞 1越雷 1陈顺伦 1胡博 1李淳德 1邑晓东 1李宏 1卢海霖 1王宇1
作者信息
摘要
Abstract
Objective:To investigate the clinical effectiveness of polytheretherketone (PEEK) cages assisted anterior cervical discetomy and fusion (ACDF) to treat cervical spondylosis with sympathetic symptoms.Methods:Retrospective analysis was undertaken for 39 patients who were diagnosed as cervical spondylosis with sympathetic symptoms and underwent ACDF with PEEK cages.Radiographs obtained before surgery,after surgery,and at the final follow-up were assessed for quality of fusion.The following criteria were used for assessing radiographic success of fusion:(1) endplate obliterated with no lucent lines;(2) obliteration of disc space by bony trabeculae;(3) less than 2°of intervertebral motion or 2 mm of motion between the spinous processes at the operated segment on flexion-extension lateral radiographs.The sympathetic symptoms including vertigo,headache,tinnitus,nausea and vomiting,heart throb,hypomnesia and gastroenterological discomfort were scored by 20-point system preoperatively,2 months postoperatively and at the final follow-up.The recovery rate and clinical satisfaction rate were also evaluated.Surgical complications were also assessed.Results:They were followed up for at least one year.The mean follow-up was 15.6 months.Radiographs of the cervical spine at the last follow-up revealed a solid fusion with no signs of a pseudoarthrosis in 36 cases.In two patients delayed union and bony fusion were achieved at the end of 9 and 11 months.Pseudoarthosis was found in 1 case but the patient had no symptoms.The score of sympathetic symptoms before surgery,2 months after surgery and at the final follow-up were 8.4 ± 1.0,2.2 ±0.3,and 2.4 ±0.3,respectively.There were 22 excellent cases,15 good cases,1 fair case and 1 bad case in terms of RR.Good to excellent results were attained in 95 ％ of theses patients.The sympathetic symptoms improved in all the patients and the score was significantly improved after surgery.There was one patient who had cerebral spinal fluid leakage but he recovered one week after surgery.Two patients felt a mild swallowing discomfort,but it disappeared within one month after surgery.Subcutaneous hematoma occurred in one patient due to obstructed drainage.It was cleared two days after surgery.Conclusion:Cervical spondylosis patients with sympathetic symptoms may be managed successfully with ACDF using PEEK cages.Successful clinical results regarding symptom improvement and general satisfaction with the surgical procedure depend not only on obtaining successful decompression and radiographic fusion but also on patient selection.关键词
前路/椎间融合/治疗/交感神经症状/颈椎病/头晕Key words
Anterior procedure/Cervical discectomy and fusion/Treatment/Cervical spondylosis/Sympathetic symptoms/Vertigo分类
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刘洪,于峥嵘,孙浩林,王诗军,赵耀,漆龙涛,王瑞,越雷,陈顺伦,胡博,李淳德,邑晓东,李宏,卢海霖,王宇..前路椎间盘切除椎间融合术治疗伴有交感神经症状的颈椎病[J].北京大学学报（医学版）,2018,50(2):347-351,5.
