RESUMO
Cervical spondylolysis is defined as a corticated cleft between the superior and inferior articular facets of the articular pillar, which is the cervical equivalent of pars interarticularis in the lumbar spine. It is very important to avoid confusion with more clinically significant abnormalities, such as fracture or dislocation. This case report describes bilateral spondylolysis and associated dysplasia of C6. We describe the radiographic presentation of this anomaly, stressing the importance of computed tomography and magnetic resonance imaging for a correct diagnosis. A review of the literature on this interesting abnormality and a complete differential diagnosis are presented.
Assuntos
Diagnóstico Diferencial , Luxações Articulares , Imageamento por Ressonância Magnética , Coluna Vertebral , EspondilóliseRESUMO
STUDY DESIGN: This is a retrospective study. OBJECTIVES: We analyzed the radiological and clinical results to verify the efficacy of anterior interbody fusion with using cages gradually increases in the treatment of cervical radiculopathy. SUMMARY OF LITERATURE REVIEW: Anterior cervical decompression and fusion is well accepted treatments for cervical radiculopathy. Performing anterior interbody fusion using cages has recently gradually increased to minimize the extent of surgery. While there are numerous reports on the primary stabilizing effects of the cervical cages, little is known about the subsidence behavior of such cages in vivo. MATERIALS AND METHODS: We retrospectively analyzed 38 patients with cervical disc herniation who underwent anterior decompression and interbody fusion with autoiliac bone graft and plate fixation (Group I, 21 patients) or who underwent with standalone cage (Group II, 17 patients). We statistically analyzed the changes of the cervical lordosis, the segmental lordosis, the vertebral body height, the fusion rate on the plain x-ray and the clinical results with using a pain visual analogue scale. RESULTS: All the cases were fused by 11.2+/-2.7 weeks after operation. The changes of the cervical lordosis and segmental lordosis show no statistically significant difference between the two groups (p=0.07, 0.66). The anterior and posterior vertebral heights of the fused segments of group II were more decreased than those of group I, but there was no statistically difference between the two groups (p=0.06, 0.30). The clinical results were not statistically difference between the two groups (p=0.64, 0.45). CONCLUSIONS: Implantation of autoiliac cancellous bone impacted stand-alone cages or on a tricortical iliac crest autograft after anterior decompression was safe and reliable options for the treatment of cervical disc herniation that causes single level radiculopathy. Both procedures produced equally satisfying clinical and radiological results, leading to a high fusion rate and they maintained the intervertebral height.