Revision surgery in the patients with cervical spondylosis after anterior decompression / 中华骨科杂志

ABSTRACT

Objective To study the causes, technique, selection and results of revision surgery in the patients with cervical spondylosis after anterior decompression. Methods Twenty nine patients with cervical spondylosis were treated with revision surgery after anterior decompression. Among them, there were 19 patients with cervical myelopathy, 8 with combination of myelopathy and radiculopathy, and 2 with radiculopathy only. The procedures included removal of the residual compressive elements, migrated bone grafts and implants, and refusion with bone graft and internal fixation. Depending on the clinical symptoms and findings of physical examination, X ray films and MRI were used to analyze the causes and the results of the revision surgery. Results There were 11 patients with incomplete initial decompression, 4 patients with the migration of the bone graft, 4 patients with new neural compression after cages interbody fusion, 2 patients with loose and migration of the plates and 8 patients with the degenerative changes in adjacent segments. Solid fusion in 23 cases and delayed fusion in 6 cases were observed during follow up. The neural recovering rate after the revision surgery was 52.4% in the patients with cervical myelopathy and 46.7% in the patients with combination of myelopathy and radiculopathy. Conclusion The main causes for the reoperation after anterior decompression were residual or newly formed neural compression. The complete decompression and segmental stabilization in the cervical revision surgery was essential for obtaining the good results.