THE CHOICE OF THE OPERATIVE APPROACHES FOR CERVICAL SPONDYLOPATHY
- VernacularTitle:颈椎病手术入路的选择
- Author:
Yuanzheng ZHANG
;
Dongyuan CHENG
;
Huaia XUE
- Publication Type:Journal Article
- Keywords:
neurosurgical procedures;
cervical spondylopathy;
operative approach
- From:
Medical Journal of Chinese People's Liberation Army
1983;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Different types of cervical spondylosis treated by a vartiety of operative techniques were compared with the aim at improving quality of treatment for cervical spondylosis. 1780 operations including laminectomy, open door laminoplasty, subtotoal vertebrectomy, Cloward's technique, Smith's technique, "keyhole" decompression of the intervertebral foramina, discectomy with intervertebral fusion, intervertebral fixation with titanium cage, and fixation with titanium plate. The results showed:(1)Myelopathy in 363 cases: laminectomy on 4; subtotoal vertebrectomy on 136; Cloward's technique on 201; Smith's technique on 4; intervertebral fixed with titanium on 4; discectomy with fusion on 14. 104 cases were followed up, 82 7% of them showed good and excellent recovery. (2)Myeloradiculopathy in 1106 cases: laminectomy on 3; laminoplasty on 143; subtotoal vertebrectomy on 687; Cloward's technique on 263; Smith's technique on 2; discectomy with fusion on 8. 396 cases were fouowed up, 85 6% of them showed good and excellent recovery. (3)Radiculopathy in 35 cases: posterior approach key hole decompression of the intervertebral foramina on 19; lateral approach decompression of the intervertebral foramina on 9; anterior approach decompression of the intervertebral foramina on 7. Good and excellent results reached 100%. (4)Vertebral artery compression in 9 cases: resection of the osteophyte of the uncinate processes on 5; opening of the transverse foramen on 4. The results were good. (5)Esophagus compression in 18: after removing directly the osteophyte, the symptoms disappeared. (6)Ossification of the posterior longitudinal ligament in 93 cases: subtotal vertebrectomy on 39; laminoplasty on 45; laminectomy on 9. 41 cases were followed up, good and excellent recovery was seen in 85 3%. (7)Cervical stenosis in 156 cases: laminoplasty on 149 and laminectomy on 7. Good and excellent recovery was observed in 97 5%. All the results indicated that a variety of operative techniques could be selected depending on the site of the osteophytes. Direct resection of the lesion which produced compression and fixation or fusion of vertebral bodies were both important to achieve a satisfactory result
