首页> 外文期刊>Spine >Multilevel Corpectomy With Anterior Column Reconstruction and Plating for Subaxial Cervical Osteomyelitis
【24h】

Multilevel Corpectomy With Anterior Column Reconstruction and Plating for Subaxial Cervical Osteomyelitis

机译:多级全切除术结合前柱重建和钢板治疗颈下椎体骨髓炎

获取原文
获取原文并翻译 | 示例
获取外文期刊封面目录资料

摘要

Study Design.A retrospective case series.Objective.The aim of this study was to evaluate patients with cervical spine osteomyelitis who underwent multilevel (2) subaxial corpectomies and anterior column reconstruction and plating.Summary of Background Data.Neglected multilevel subaxial cervical osteomyelitis is a potentially dangerous disease. As it is rare, early radiographic and clinical outcomes after multilevel anterior corpectomy and reconstruction for subaxial cervical osteomyelitis are incompletely defined.Methods.Adults who underwent multilevel corpectomy and anterior plating/reconstruction for subaxial cervical osteomyelitis at two institutions were reviewed. Analysis of patient demographics, operative details, and radiographic cervical alignment parameters [segmental kyphosis, cervical lordosis, C2-7 sagittal vertical axis (SVA)] was performed.Results.Nineteen patients [15 males, four females; average age 48 years (20-81 yrs)] met inclusion criteria. The majority had pre-operative neurologic deficits or was immunosuppressed. All were treated with 6 weeks of intravenous antibiotics following operation. All had anterior plating/reconstruction with titanium cages (expandable-6; mesh-6) or structural bone graft (fibular allogaft-6; tricortical iliac crest-1). The average number of corpectomies was 2.4 (2-4). The average numbers of levels fused anteriorly was 4.4 (4-6) and posteriorly was 6.3 (4-9). The majority of patients (74%) was treated with an anterior/posterior approach. Average follow-up was 169 months. There was significant improvement in all cervical alignment parameters (segmental kyphosis, C2-7 SVA, cervical lordosis). No intraoperative complications occurred and no patient deteriorated neurologically postoperatively. Postoperative complications included anterior cage/graft dislodgement (n=2), recurrent neck hematomas requiring revision (n=1), epidural hematoma (n=1), and wound infection (n=1). Sixty percent of patients had persistent neurologic dysfunction at final follow-up. None required reoperation for recurrent infection or pseudarthrosis.Conclusion.Although overall prognosis and neurologic recovery are guarded in medically fragile patients with multilevel subaxial cervical osteomyelitis, reconstruction with multilevel (2) corpectomy and anterior reconstruction/plating results in excellent restoration of cervical alignment and low rates of recurrent infection and pseudarthrosis.Level of Evidence: 4
机译:研究设计,回顾性病例系列,目的。本研究的目的是评估经历多级(2)亚轴皮层切除术并进行前柱重建和铺板的颈椎骨髓炎患者。背景数据摘要。潜在危险的疾病。罕见的是,对于亚轴颈骨髓炎的多级前路全切除术和重建术后的早期影像学和临床结果尚不完全明确。结果:19例患者[男15例,女4例;男性15例,女性4例;颈椎前凸,颈椎前凸,C2-7矢状垂直轴(SVA)]进行了分析。平均年龄48岁(20-81岁)]符合纳入标准。多数患者术前有神经功能缺损或被免疫抑制。术后均用6周静脉抗生素治疗。所有患者均采用钛笼(可扩张6;网状6)或结构性骨移植物(腓骨同种异体6 ;;皮质三rest 1)进行前板电镀/重建。解剖平均数为2.4(2-4)。前融合水平的平均数为4.4(4-6),后融合为6.3(4-9)。大多数患者(74%)采用前/后入路治疗。平均随访169个月。所有颈椎对位参数(节段性后凸畸形,C2-7 SVA,颈椎前凸畸形)都有显着改善。术中无并发症发生,术后无神经功能恶化。术后并发症包括前笼/移植物移位(n = 2),需要翻修的复发性颈部血肿(n = 1),硬膜外血肿(n = 1)和伤口感染(n = 1)。在最后的随访中有60%的患者患有持续的神经功能障碍。结论:尽管在医学上脆弱的多级亚轴颈骨髓炎患者中,总体预后和神经系统恢复得到了保护,但多级(2)体切除术和前路重建/钢板重建可确保良好的颈椎对位和低位复位反复感染和假关节的发病率。证据级别:4

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱:kefu@zhangqiaokeyan.com

京公网安备:11010802029741号 ICP备案号:京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有
  • 客服微信

  • 服务号