Abstract

BACKGROUND

Expandable cages are often used to reconstruct cervical corpectomies but there are few long-term follow-up studies with large numbers.

OBJECTIVE

To analyze the clinical and radiographic results of cervical corpectomy reconstructed with expandable cages for degenerative stenosis.

METHODS

We performed a retrospective analysis of 78 patients with degenerative cervical stenosis treated with a corpectomy reconstructed with an expandable cage. We evaluated the clinical and radiographic outcomes, as well as complications of the procedure at a minimum 2-yr follow-up.

RESULTS

There was a decrease in the visual analog scale pain average from 75 mm to 8.5 mm (P = .02); a decrease in the Neck Disability Index average from 55% to 12% (P = .009); and improvement in the Japanese Orthopaedic Association average from 12 to 14 points (P = .01). There was a change in cervical lordosis (Cobb method) average from −9.3° to −15.1° (P = .002), without significant loss of lordosis (P = .63). The fusion rate, by criteria of the Cervical Spine Research Society (CSRS), was low: using dynamic X-rays – 50% (n = 39/78) and using computed tomography (CT) – 47.4% (n = 37/78). A total of 11 patients (14.1%) suffered complications.

CONCLUSION

To our knowledge, this is the largest series (78) with a minimum 2-yr follow-up in the literature and the first using the dynamic radiographic and CT criteria endorsed by the CSRS. Using these criteria, our fusion rates were much lower than all previous reports in the literature. Despite this, patient-reported outcomes were reasonable. There was a relatively low incidence of perioperative complications, most of which were likely not implant-specific and there was only 1 case of implant failure.

中文翻译：

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用可扩展的笼子重建颈椎椎体切除术后融合率差：至少 2 年的放射学和临床结果

摘要

背景

可扩展的笼子通常用于重建宫颈切除术，但很少有大量的长期随访研究。

客观的

分析可扩张椎间融合器重建颈椎椎体切除术治疗退行性狭窄的临床和影像学结果。

方法

我们对 78 名接受可扩张椎间融合器重建的椎体切除术治疗的退行性颈椎管狭窄症患者进行了回顾性分析。我们在至少 2 年的随访中评估了临床和影像学结果以及手术并发症。

结果

视觉模拟量表疼痛平均值从 75 毫米降低到 8.5 毫米（P  = .02）；颈部残疾指数平均值从 55% 下降到 12% ( P  = .009)；日本骨科协会平均水平从 12 分提高到 14 分（P  = .01）。颈椎前凸（Cobb 方法）平均值从 -9.3° 变为 -15.1° ( P  = .002)，而没有显着的前凸丧失 ( P  = .63)。根据颈椎研究协会 (CSRS) 的标准，融合率较低：使用动态 X 射线 – 50% (n = 39/78) 和使用计算机断层扫描 (CT) – 47.4% (n = 37/78) ）。共有 11 名患者 (14.1%) 出现并发症。

结论

据我们所知，这是文献中最少 2 年随访的最大系列 (78)，也是第一个使用 CSRS 认可的动态放射照相和 CT 标准的系列。使用这些标准，我们的融合率远低于文献中所有以前的报告。尽管如此，患者报告的结果是合理的。围手术期并发症的发生率相对较低，其中大部分可能不是种植体特异性的，只有 1 例种植体失败。