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Eur Spine J ; 26(4): 1246-1253, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28185064

RESUMO

PURPOSE: The purpose of this study was to assess long-term follow-up data after anterior cervical decompression and fusion (ACDF) with and without Caspar plating (ACDF + PS) for the treatment of cervical spondylotic myelopathy (CSM) with special focus on functional outcome, pain, and repeat surgery for adjacent segment disease (ASD). METHOD: Hospital records of 45 patients who were affected by CSM and underwent ACDF or ACDF + PS at least 17 years ago were reviewed. Information about diagnosis, surgical report, pre- and postoperative clinical process, and complications was analyzed. Clinical outcome was assessed using a standardized questionnaire including the Neck Disability Index (NDI), modified JOA-score, Odom's criteria, limitations in quality of life, and questions about the current neurological status and pain. RESULTS: Twenty-three patients with a mean follow-up of 26 years were evaluated. ACDF was performed in nine and ACDF + PS in 14 patients, respectively. At follow-up 78.3% of patients were free of pain, 91.3% had no motor deficit, 73.9% had no sensory deficit, and 60.7% had no gait disturbance. The current mean NDI is 14% (range 2-44%), the mean modified JOA-score was 17.2 (range 15-18). According to Odom's criteria 78.3% of patients had clinical success. In four patients repeat surgery was indicated due to pseudarthrosis or symptomatic ASD (17.4%). CONCLUSIONS: ACDF and ACDF + PS yield significant decrease in neck pain, a significant increase in sensorimotor function and a high rate of clinical success. Patients with preoperative gait disturbance completely recovered in about 60% of cases. Overall prevalence for ASD was 17.4% after 25 years.


Assuntos
Placas Ósseas , Vértebras Cervicais/cirurgia , Descompressão Cirúrgica/métodos , Fusão Vertebral/métodos , Espondilose/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Marcha , Humanos , Masculino , Pessoa de Meia-Idade , Espasticidade Muscular/etiologia , Espasticidade Muscular/cirurgia , Cervicalgia/etiologia , Cervicalgia/cirurgia , Medição da Dor , Recuperação de Função Fisiológica , Reoperação , Estudos Retrospectivos , Transtornos de Sensação/etiologia , Transtornos de Sensação/cirurgia
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