ZHU Yunrong,JIANG Yuquan,HU Hongtao.Clinical study of a cervical anterior hybrid technique for multilevel cervical spondylotic myelopathy[J].Chinese Journal of Spine and Spinal Cord,2011,(11):910-914.
Clinical study of a cervical anterior hybrid technique for multilevel cervical spondylotic myelopathy
Received:June 10, 2011  Revised:July 13, 2011
English Keywords:Cervical myelopathy  Multilevel  Disc replacement  Fusion  Hybrid technique
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Author NameAffiliation
ZHU Yunrong Department of OrthopedicsChangzheng HospitalSecond Military Medical UniversityShanghai 200003China 
JIANG Yuquan 第二军医大学附属上海长征医院脊柱外科 200003 上海市凤阳路415号 
HU Hongtao 第二军医大学附属上海长征医院脊柱外科 200003 上海市凤阳路415号 
刘继春  
许国华  
何海龙  
叶晓健  
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English Abstract:
  【Abstract】 Objective:To explore the early clinical effects of cervical anterior hybrid technique using anterior corpectomy and fusion(ACF) combined with cervical artificial disc replacement(C-ADR) for multilevel spondylotic myelopathy.Method:Hybrid technique was applied in 24 cases of multilevel cervical spondylotic myelopathy(group A),and 28 patients were treated by the traditional anterior noncontiguous decompression and fusion(group B) between Oct 2008 and Jun 2009. Clinical results were evaluated by JOA score preoperatively and postoperatively at 3d,3 months,12 months,and 24 months.The operative time and blood loss were recorded.The range of movement(ROM) in replaced segment and C2-7 of all cases were evaluated by radiograph(X-rays of bending,extending).CT or MRI scan was applied postoperatively to find out the pressure of the spine and heterotopic ossification in the replaced segment.Result:There was no serious complication.Improvement in all cases occurred obviously,and JOA score increased(P<0.01) and stabilized postoperatively in all cases.There was no difference in JOA score between two groups(P>0.05).The mean C2-7 ROM of both groups did not recover to the preoperative value,but group A showed faster and better C2-7 ROM recovery.Replaced segment achieved stability and restored partial of ROM.There was no prosthesis subsidence or excursion.No hetertopic ossification was found in the replaced level,and the movement had no significant difference(P>0.05) between preoperative and postoperative at two years post-operation.But the deteriorated adjacent level of 2 cases were found in group B.Conclusion:In term of surgical time,blood loss and restoring stability and partial motion of the C2-7 ROM,the anterior hybrid technique is superior compared with the traditional anterior noncontiguous decompression and fusion.At the same time,less compensatory motion occurs at the adjacent segments,and less ASD will result.
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