頚椎症性脊髄症に対する術後成績
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概要
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We reviewed retrospectively the clinical results of 211 patients with cervical spondylotic myelopathy were surgically treated from 1993 to 2002. The average age at the time of surgery was 60 years (range 32 to 83 years). The average follow-up period was 46.6 months (range 6 to 134 months). Sixty-three patients underwent anterior interbody fusion (group A) and 148 patients underwent laminoplasty (group E). The outcome was assessed functionally and radiographically. The functional assessment was according to the Japanese Orthopaedic Association (JOA) score, recovery ratio (RR). The radiographic outcome was assessed by sagittal alignment, canal space, and the union of grafted bone. The average age at the time of surgery was 52.9 years in group A and 63.0 years in group E (p<0.05). The mean preoperative JOA score was 10.6 in group A and 9.1 in group E (p<0.05). There were no significant differences in RR between group A (64.2%) and group E (59.1%). The preoperative alignment of cervical spine was not associated with clinical results in group E. However, one patient in group E required anterior interbody fusion because of progression of kyphosis and recurrent myelopathy. The presence of pseudoarthrosis was not associated with clinical results in group A. Three patients in group A required laminoplasty because of recurrent myelopathy at adjacent disc space or pseudoarthrosis. Those three patients also had developmental canal stenosis. We cannot compare group A and E directly, because the preoperative backgrounds of these two groups were different. Both laminoplasty and anterior interbody fusion resulted in satisfactory clinical outcome. However, choice of the appropriate method depends on the patient's background.
- 中国・四国整形外科学会の論文
中国・四国整形外科学会 | 論文
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