CONTRASTIVE ANALYSIS OF NECK AXIAL SYMPTOMS AFTER HYBRID SURGERY OR TRADITIONAL ANTERIOR CERVICAL DISCECTOMY AND FUSION FOR TREATMENT OF TWO-LEVEL CERVICAL DISEASE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SHEN Canghai , SHEN Yong , DING Wenyuan , ZHANG Yingze , CAO Junming.

Department of Spinal Surgery, the Third Affiliated Hospital of Hebei Medical University, Shijiazhuang Hebei, 050051, P.R.China. Corresponding author: SHEN Yong, E-mail: shenyongspinemd@163.com;

Corresponding author：

Keywords：

Two-level cervical spondylosis; Hybrid surgery; Intervertebral fusion; Axial symptom

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the occurrence condition of the neck axial symptom (AS) after cervical Bryan artificial disc replacement combined with anterior cervical discectomy and fusion (Hybrid surgery) and traditional anterior cervical discectomy and fusion (ACDF surgery) to treat the two-level cervical disease, and to do contrastive analysis. Methods Between August 2006 and March 2010, 18 patients underwent Hybrid surgery (group A) and 30 patients underwent two-level ACDF surgery (group B). There was no significant difference in age, gender, disease duration, type, and operated segment between 2 groups (P gt; 0.05). The Japanese Orthopaedic Association (JOA) score, neck disability index (NDI) score, cervical curvature of the operated segment, total range of motion (ROM) of C2-7, ROM of the adjacent segment, and incidence of neck AS were recorded and compared between before operation and at last follow-up. Results All the patients were followed up 18-34 months (24.1 months on average). In both groups, the JOA and NDI scores at last follow-up had significantly improvement when compared with preoperative scores (P lt; 0.01), but there was no significant difference between 2 groups at preoperation and last follow-up (P gt; 0.05). The kyphosis incidence of the operated segment in group B was significantly higher than that in group A (χ2=5.333, P=0.021). There was no significant difference in the total ROM of C2-7 between at preoperation and last follow-up in group A (t=0.410, P=0.685); the total ROM of C2-7 at last follow-up was significantly lower than that at preoperation in group B (t=3.007, P=0.006); and significant difference was found between 2 groups at last follow-up (t=2.664, P=0.013). At last follow-up, ROM of the superior and inferior adjacent segments in group B increased obviously (P lt; 0.05) and was significantly higher than that in group A (t=2.252, P=0.033; t=2.203, P=0.037). The incidence of neck AS were 16.7% in group A and 46.7% in group B, showing significant difference at last follow-up (χ2=4.427, P=0.035). Conclusion Compared with two-level ACDF surgery, Hybrid surgery has good outcomes. At the same time, it can maintain the curvature of operated segments and total ROM, avoid excessive increased ROM of the adjacent segments, and reduce the incidence of neck AS.

Citation： SHEN Canghai,SHEN Yong,DING Wenyuan,ZHANG Yingze,CAO Junming.. CONTRASTIVE ANALYSIS OF NECK AXIAL SYMPTOMS AFTER HYBRID SURGERY OR TRADITIONAL ANTERIOR CERVICAL DISCECTOMY AND FUSION FOR TREATMENT OF TWO-LEVEL CERVICAL DISEASE. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(1): 58-61. doi: Copy

1.	曾岩, 党耕町, 马庆军. 颈椎前路术后融合节段曲度变化与轴性症状和神经功能的相关性研究. 中国脊柱脊髓杂志, 2004, 14(9): 520-523.
2.	曹俊明, 申勇, 杨大龙, 等. Bryan人工颈椎间盘置换与颈前路椎间融合术后轴性症状的对比分析. 中国修复重建外科杂志, 2008, 22(10): 1200-1204.
3.	田伟, 刘波, 李勤, 等. 人工颈椎间盘置换手术的临床初步应用体会. 中华医学杂志, 2005, 85(1): 37-40.
4.	Shin DA, Yi S, Yoon do H, et al. Artificial disc replacement combined with fusion versus two-1evel fusion in cervical two-level disc disease. Spine (Phila Pa 1976), 2009, 34(11): 1153-1161.
5.	任先军, 王卫东, 初同伟, 等. 椎间盘置换联合邻近节段cage融合治疗双节段颈椎间盘突出症的近期疗效. 中国脊柱脊髓杂志, 2009, 19(11): 840-844.
6.	刘海鹰, 许晓诺, 王波, 等. 双节段Hybrid手术治疗颈椎病的临床疗效观察. 中华外科杂志, 2012, 50(3): 238-242.
7.	曾岩, 党耕町, 马庆军. 颈椎前路融合术后颈部运动功能的评价. 中华外科杂志, 2004, 42(24): 1481-1484.
8.	Fukui K, Kataka O, Sho T, et al. Pathomechanism, pathogenesis, and results of treatment in cervical spondylotic myelopathy caused by dynamic canal stenosis. Spine (Phila Pa 1976), 1990, 15(11): 1148-1152.
9.	潘胜发, 孙宇, 朱振军, 等. 单开门颈椎管扩大椎板成形术后轴性症状与颈椎稳定性的相关观察. 中国脊柱脊髓杂志, 2003, 13(10): 604-607.
10.	Goffin J, van Calenbergh F, van Loon J, et al. Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level. Spine (Phila Pa 1976), 2003, 28(24): 2673-2678.
11.	Sekhon LH. Cervical arthroplasty in the management of spondylotic myelopathy. J Spinal Disord Tech, 2003, 16(4): 307-313.
12.	杨大龙, 申勇, 曹俊明, 等. 颈人工椎间盘置换近期并发症分析. 中国脊柱脊髓杂志, 2008, 18(4): 249-252.
13.	Kim SW, Shin JH, Arbatin JJ, et al. Effects of a cervical disc prosthesis on maintaining sagittal alignment of the functional spinal unit and overall sagittal balance of the cervical spine. Eur Spine J, 2008, 17(1): 20-29.
14.	贾连顺, 李家顺. 颈椎外科手术学. 上海: 上海远东出版社, 2001: 139-141.
15.	Liu J, Ebraheim NA, Sanford CG, et al. Preservation of the spinous process-ligament-muscle complex to prevent kyphotic deformity following laminoplasty. Spine (Phila Pa 1976), 2007, 7(2): 159-164.
16.	Shim CS, Lee SH, Park HJ, et al. Early clinical and radiologic outcomes of cervical arthroplasty with Bryan Cervical Disc prosthesis. J Spinal Disord Tech, 2006, 19(7): 465-470.
17.	张为, 申勇, 丁文元, 等. 人工颈椎间盘置换术治疗脊髓型颈椎病的临床观察. 中国矫形外科杂志, 2006, 14(15): 1124-1126, i0001.
18.	Cao JM, Zhang YZ, Shen Y, et al. Clinical and radiological outcomes of modified techniques in Bryan cervical disc arthroplasty. J Clin Neurosci, 2011, 18(10): 1308-1312.
19.	Cho BY, Lim J, Sim HB, et al. Biomechanical analysis of the range of motion after placement of a two-1evel cervical ProDisc-C versus hybrid construct. Spine (Phila Pa 1976), 2010, 35(19): 1769-1776.

1. 曾岩, 党耕町, 马庆军. 颈椎前路术后融合节段曲度变化与轴性症状和神经功能的相关性研究. 中国脊柱脊髓杂志, 2004, 14(9): 520-523.
2. 曹俊明, 申勇, 杨大龙, 等. Bryan人工颈椎间盘置换与颈前路椎间融合术后轴性症状的对比分析. 中国修复重建外科杂志, 2008, 22(10): 1200-1204.
3. 田伟, 刘波, 李勤, 等. 人工颈椎间盘置换手术的临床初步应用体会. 中华医学杂志, 2005, 85(1): 37-40.
4. Shin DA, Yi S, Yoon do H, et al. Artificial disc replacement combined with fusion versus two-1evel fusion in cervical two-level disc disease. Spine (Phila Pa 1976), 2009, 34(11): 1153-1161.
5. 任先军, 王卫东, 初同伟, 等. 椎间盘置换联合邻近节段cage融合治疗双节段颈椎间盘突出症的近期疗效. 中国脊柱脊髓杂志, 2009, 19(11): 840-844.
6. 刘海鹰, 许晓诺, 王波, 等. 双节段Hybrid手术治疗颈椎病的临床疗效观察. 中华外科杂志, 2012, 50(3): 238-242.
7. 曾岩, 党耕町, 马庆军. 颈椎前路融合术后颈部运动功能的评价. 中华外科杂志, 2004, 42(24): 1481-1484.
8. Fukui K, Kataka O, Sho T, et al. Pathomechanism, pathogenesis, and results of treatment in cervical spondylotic myelopathy caused by dynamic canal stenosis. Spine (Phila Pa 1976), 1990, 15(11): 1148-1152.
9. 潘胜发, 孙宇, 朱振军, 等. 单开门颈椎管扩大椎板成形术后轴性症状与颈椎稳定性的相关观察. 中国脊柱脊髓杂志, 2003, 13(10): 604-607.
10. Goffin J, van Calenbergh F, van Loon J, et al. Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level. Spine (Phila Pa 1976), 2003, 28(24): 2673-2678.
11. Sekhon LH. Cervical arthroplasty in the management of spondylotic myelopathy. J Spinal Disord Tech, 2003, 16(4): 307-313.
12. 杨大龙, 申勇, 曹俊明, 等. 颈人工椎间盘置换近期并发症分析. 中国脊柱脊髓杂志, 2008, 18(4): 249-252.
13. Kim SW, Shin JH, Arbatin JJ, et al. Effects of a cervical disc prosthesis on maintaining sagittal alignment of the functional spinal unit and overall sagittal balance of the cervical spine. Eur Spine J, 2008, 17(1): 20-29.
14. 贾连顺, 李家顺. 颈椎外科手术学. 上海: 上海远东出版社, 2001: 139-141.
15. Liu J, Ebraheim NA, Sanford CG, et al. Preservation of the spinous process-ligament-muscle complex to prevent kyphotic deformity following laminoplasty. Spine (Phila Pa 1976), 2007, 7(2): 159-164.
16. Shim CS, Lee SH, Park HJ, et al. Early clinical and radiologic outcomes of cervical arthroplasty with Bryan Cervical Disc prosthesis. J Spinal Disord Tech, 2006, 19(7): 465-470.
17. 张为, 申勇, 丁文元, 等. 人工颈椎间盘置换术治疗脊髓型颈椎病的临床观察. 中国矫形外科杂志, 2006, 14(15): 1124-1126, i0001.
18. Cao JM, Zhang YZ, Shen Y, et al. Clinical and radiological outcomes of modified techniques in Bryan cervical disc arthroplasty. J Clin Neurosci, 2011, 18(10): 1308-1312.
19. Cho BY, Lim J, Sim HB, et al. Biomechanical analysis of the range of motion after placement of a two-1evel cervical ProDisc-C versus hybrid construct. Spine (Phila Pa 1976), 2010, 35(19): 1769-1776.

Chinese Journal of Reparative and Reconstructive Surgery

CONTRASTIVE ANALYSIS OF NECK AXIAL SYMPTOMS AFTER HYBRID SURGERY OR TRADITIONAL ANTERIOR CERVICAL DISCECTOMY AND FUSION FOR TREATMENT OF TWO-LEVEL CERVICAL DISEASE

Abstract Full text Figures/Tables Video References Cited by

Format

Content