Clinical and radiological results of two hybrid reconstructive techniques in noncontiguous 3-level cervical spondylosis

作者：Lisheng Kan, Jian Kang, Rui Gao, Xiongsheng Chen, Lianshun Jia · 发表于：Journal of Neurosurgery Spine · 年份：2014 · DOI：10.3171/2014.8.spine13791 · 被引用次数：19 · 研究领域：Cervical and Thoracic Myelopathy、Spine and Intervertebral Disc Pathology、Scoliosis diagnosis and treatment

OBJECT: To date, formulation of the optimal surgical protocol for noncontiguous multilevel cervical spondylosis remains controversial, and the corresponding clinical data continue to be limited. The purpose of this study was to compare the clinical and radiological outcomes of two hybrid reconstructive techniques in noncontiguous 3-level cervical spondylosis (2 contiguous disc levels and 1 "skip" disc level [nonoperated level between 2 operated levels]). The incidence of adjacent-segment degeneration (ASD) was also evaluated. METHODS: Sixty-three consecutive patients with noncontiguous 3-level cervical spondylosis who underwent two different hybrid methods of treatment were retrospectively reviewed. The patients were divided into 2 groups, the fusion group and the arthroplasty group. A titanium mesh cage and an anterior cervical plate were used after the anterior cervical corpectomy, and then a stand-alone cage (the fusion group) or an artificial cervical disc (the arthroplasty group) was used after the discectomy. Clinical outcomes were assessed using the Japanese Orthopaedic Association (JOA) scale score and the JOA scale score improvement rate preoperatively and during follow-up. Radiological results were assessed using global angle and global range of motion (ROM) of the cervical spine. The ASD was also evaluated. RESULTS: The JOA scores of the patients significantly improved postoperatively and were well maintained within the follow-up period, as did the JOA scale score ...