Total disc replacement to treat cervical spondylotic myelopathy with sympathetic symptoms
10.3760/cma.j.issn.0253-2352.2012.05.001
- VernacularTitle:颈椎间盘置换术治疗伴交感神经症状颈椎病的早期疗效
- Author:
Lei LIANG
;
Xinwei WANG
;
Wen YUAN
;
Jun LI
;
Huajiang CHEN
;
Min QI
;
Zhanchao WANG
- Publication Type:Journal Article
- Keywords:
Cervical spondylosis;
Autonomic nervous disease;
Arthroplasty,replacement
- From:
Chinese Journal of Orthopaedics
2012;32(5):389-392
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the effect of total disc replacement (TDR) in the treatment of cervical spondylotic myelopathy(CSM) with sympathetic symptoms.MethodsTwenty-seven patients (15 males and 12 females) with CSM at single level accompanied by sympathetic symptoms,who underwent TDR surgery(Prestige or Discover prosthesis) with the posterior longitudinal ligament (PLL) resected at the area of decompression between October 2008 and May 2011,were retrospectively analyzed.All patients were followed up for at least 6 months (average,15.1 months).Clinical and radiologic evaluations were obtained preoperatively,1 week postoperatively,and at the final follow-up.The sympathetic symptoms were scored by our original 20-point system.The clinical outcomes were assessed by Japanese Orthopedic Association (JOA) scoring system and the Short Form-36 Health Survey (SF-36).ResultsThe sympathetic symptoms were improved in all patients and the score was significantly improved after surgery.The sympathetic symptoms scores were (8.5±2.5) points preoperatively,(1.6±1.4) points 1 week postoperatively,and (2.3±1.1) points at the final follow-up.The patient's subjective satisfaction was excellent in 15 patients,good in 8,fair in 4,with an excellent and good rate of 85.2％.The corresponding JOA scores were(10.8±2.4) poiuts, (11.1±2.5) points,and (14.9±1.4) points,respectively.The SF-36 scores showed statistical improvements from preoperative (102.7±8.7) points to postoperative (129.8±5.5) points.Based on X-ray examination,the range of motion of the treated segment were reserved.During the follow-up period,there was no prosthesis subsidence or excursion.ConclusionThe CSM patients with sympathetic symptoms could be managed successfully with TDR.And thoroughly resection of the PLL may be the key factor for good prognosis.
