医学
颈椎前路椎间盘切除融合术
吞咽困难
脊髓病
外科
回顾性队列研究
放射性武器
颈椎
脊髓
精神科
作者
Michael A. Finn,Joel D. MacDonald
出处
期刊:Clinical spine surgery
[Ovid Technologies (Wolters Kluwer)]
日期:2013-04-23
卷期号:29 (10): E536-E541
被引量:18
标识
DOI:10.1097/bsd.0b013e318292b3ca
摘要
Study Design: Retrospective review of patients at a university hospital. Objective: To describe the anterior approach for cervical discectomy and fusion (ACDF) at C2–C3 level and evaluate its suitability for treatment of instability and degenerative disease in this region. Summary of Background Data: The anterior approach is commonly used for ACDF in the lower cervical spine but is used less often in the high cervical spine. Methods: We retrospectively reviewed a database of consecutive cervical spine surgeries performed at our institution to identify patients who underwent ACDF at the C2–C3 level during a 10-year period. Demographic data, clinical indications, surgical technique, complications, and immediate results were evaluated. Results: Of the 11 patients (7 female, 4 male; mean age 46 y) identified, 7 were treated for traumatic fractures and 4 for degenerative disk disease. Three patients treated for myelopathy showed improvement in mean Nurick grade from 3.6 to 1.3. Pain was significantly improved in all patients who had preoperative pain. Solid bony fusion was achieved in 5 of 7 patients at 3-month follow-up. Complications included dysphagia in 4 patients (which resolved in 3), aspiration pneumonia, mild persistent dysphonia, and construct failure at C2 requiring posterior fusion. One patient died of a pulmonary embolism 2 weeks postoperatively. Conclusions: ACDF at the C2–C3 level is an option for the treatment of high cervical disease or trauma but is associated with a higher rate of approach-related morbidity. Familiarity with local anatomy may help to reduce complications. ACDF at C2–C3 appears to have a fusion rate similar to ACDF performed at other levels.
科研通智能强力驱动
Strongly Powered by AbleSci AI