Anterior migration of spinal cord after anterior cervical decompression and reconstruction for cervical spondylosis
10.3760/cma.j.issn.0253-2352.2013.10.004
- VernacularTitle:颈椎前路减压植骨融合术后的脊髓前移
- Author:
Yu QIAN
;
Lei HE
;
Xiaofeng ZHAO
;
Jun ZHANG
- Publication Type:Journal Article
- Keywords:
Cervical spondylosis;
Spinal fusion;
Decompression,surgical
- From:
Chinese Journal of Orthopaedics
2013;33(10):997-1003
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate anterior migration of spinal cord after anterior cervical decompression and reconstruction for cervical spondylosis and its mechanism.Methods Eighty-one patients with cervical spondylosis who underwent anterior decompression and reconstruction were reviewed and evaluated retrospectively.There were 44 males and 37 females,with an average age of 52.3 years (range,37-72 years).The distance from anterior margin of the spinal cord to posterior wall of the spinal canal (Da),and medium of the spinal cord to posterior wall of the spinal canal (Dm) in magnetic resonance imaging were measured preoperatively and postoperatively.The recovery rate was calculated comparing the Japanese Orthopaedic Association (JOA) scores before and after operation.Results The average following up was 20.7 months (9-48 months).According to the measure on MRI,preoperative Da and Dm were 11.11±1.59 mm and 6.30±0.84 mm respectively,which were significant different from postoperative Da 11.63±-1.47 mm and Dm 6.62±0.80 mm.The postoperative Da and Dm at C3-4,C4-5,C5-6,C6-7 levels had statistically significant differences compared to preoperative Da and Dm,except for ones at C2-3 level.The significant migration rate was 43.2％(35/81),which reached △Da ＞2 mm or △Dm ＞1.3 mm.Preoperative cervical curvature index (CCI) was 10.0％±6.3％,which was significant different from postoperative CCI 13.5％±6.5％.JOA score increased from 9.7±1.5 preoperatively to 13.7±1.1 at one week postoperatively,and 13.9±1.3 at 6 months postoperatively.But the JOA score decreased at 6 months postoperatively compared with that at 1 week postoperatively in 15 cases.Among them,14 cases got the standard of spinal cord migration based on MRI measurement.No other severe complications were found in these 81 cases.Conclusion Anterior migration of the spinal cord commonly occurred after cervical decompression and reconstruction via anterior approach,and some patients might suffer from the secondary compression of the cervical spinal cord.
