RESUMEN
<p><b>OBJECTIVE</b>To study the microsurgical decompression combined with cervical artificial disc replacement clinical efficacy for the treatment of cervical spondylosis.</p><p><b>METHODS</b>From January 2006 to November 2011, 21 cases of cervical spondylosis, totally 23 intervertebral spaces, were under the microscope disc decompression and cervical artificial disc replacement. There were 11 male and 10 female patients; aged from 28 to 60 years, with an average of 46.3 years. The diagnosis included 5 cases of nerve root type cervical spondylosis and 16 cases of cervical spondylotic myelopathy. Application of Bryan prosthesis treatment of 9 patients, a total of 10 intervertebral spaces; ProDisc-C prosthesis to treat 12 patients, a total of 13 intervertebral space. Following-up Japanese Orthopedic Association (JOA), neck disability index (NDI) and visual analogue scale (VAS) scores were recorded and compared with pre-operative scores by the paired t-test.</p><p><b>RESULTS</b>The patients were followed up for 6 to 74 months, with an average of 27.7 months. Although a patient with spinal bony stenosis symptom improved, but not satisfied, and after the posterior decompression, who had a better prognosis. The remaining patients during follow-up symptoms were obvious improved, and the replacement segments were stable. There was no prosthesis subsidence and significantly offset. In 1 month post-operation and last follow-up compared with pre-operative scores, JOA (t = 9.195 and 17.070), NDI (t = 7.193 and 14.062) and VAS (t = 14.851 and 16.133) scores were significantly different (P < 0.05); and 1 month post-operation compared with last follow-up, JOA (t = 5.916), NDI (t = 7.722) and VAS (t = 4.564) scores were significantly different (P < 0.05).</p><p><b>CONCLUSIONS</b>Cervical artificial disc replacement combined with microscopic decompression surgery can completely remove the oppression of nerve tissue caused by pressure, and the efficacy is more secure.</p>
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vértebras Cervicales , Cirugía General , Descompresión Quirúrgica , Métodos , Microcirugia , Osteofitosis Vertebral , Cirugía General , Estenosis Espinal , Cirugía General , Reeemplazo Total de Disco , Resultado del TratamientoRESUMEN
Objective To discuss the microsurgical strategies in patients with intramedullary tumors in the cervical spinal cord and their efficacy evaluation. Methods The clinical manifestations, imaging features, diagnoses of 11 patients with intramedullary tumors in the cervical spinal cord were analyzed retrospectively: the tumors on these patients were resected by microneurosurgery in our hospital during Jan 2006 and Dec 2008; the tumor resection degree was measured and the preoperative or postoperative nerve function was evaluated. Results Of the 11 patients with intramedullary tumors, total resection and subtotal resection were achieved in 8 and 3, respectively. Postoperative nerve functions were alleviated in 7, unchanged in 3 and aggravated in 1. No patient died. Conclusion Appropriate operative strategies and practiced microsurgical technique are the foundation of improving the clinical curative effect of the intramedullary tumors in the cervical spinal cord.