Subtotal corpectomy with the posterior vertebral wall retention for the extensive decompression
- VernacularTitle:保留椎体后壁的椎体次全切除扩大减压术
- Author:
Wen YUAN
;
Xinwei WANG
;
Deyu CHEN
- Publication Type:Journal Article
- Keywords:
Cervical spondylosis;
Decompression, surgical;
Neurosurgical procedures
- From:
Chinese Journal of Orthopaedics
2000;0(11):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To report a newly designed method of cervical subtotal corpectomy with the posterior vertebral wall retention. Methods 89 cases of cervical spondylotic myelopathy(CSM) or cervical injury were treated with subtotal corpectomy with the posterior vertebral wall retention from March 2001 to March 2004. 61 males and 28 females, aged from 25 to 76 years(mean, 47 years) were included, which involved 62 cases of multiple level in CSM with or without radiculopathy, 14 fractures of cervical vertebral body with or without cervical dislocation, 13 cervical instability with or without cervical disc disease. Subtotal corpectomy with 2 mm retention in posterior wall of the vertebral body were performed, in which 23 cases' level were C4,55 C5 and 11 C6. Extensive decompression through intervertebral body space was performed and bone fusion with autogenous iliac bone graft or titanium mesh supplemented with anterior locking plates were used, the bone graft or mesh were impacted into the decompression slot between the upper to lower endplate as well as the preserved lateral and posterior wall stably. Bone fusion were assessed with roentgenogram during the 3rd, 6th, 12th month follow-up and neurological function was recorded. Results The average operation time is 100 min, ranged from 55-130 min, the blood loss were 120 ml, ranged from 30 to 300 ml. Neither plate or screw migration, nor bone graft loosening or subsidence were found in 77 patients with over 6 months follow-up. Bone fusion happened in all patients, and Frankel score improved 1.0 level averagely after operation. 3 patients with hoarseness recovered 2 weeks later. Conclusion Subtotal corpectomy with posterior wall of vertebrae retention was a feasible anterior decompression procedure with advantage of safety, completely decompression and reliable bone fusion. This method included double level of CSM, and cervical fracture as well as two level of local ossification of posterior longitudinal ligament.
