| 孔祥溢 钟卓霖 翟吉良 杨义 胡建华.颈前路椎管减压术后复发致邻近节段颈髓受压：1 例报道及相关原因探讨[J].,2015,15(26):5053-5055 |
| 颈前路椎管减压术后复发致邻近节段颈髓受压：1 例报道及相关原因探讨 |
| Adjacent Segmental Cervical Spinal Compression caused by AnteriorCervical Fusion: a Case Report and Reasons Discussion |
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| DOI： |
| 中文关键词: 颈前路椎管减压术 复发 再狭窄 原因 |
| 英文关键词: Spinal canal anterior decompression Recurrence Restenosis Reason |
| 基金项目:国家自然科学基金项目(81301061) |
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| 中文摘要: |
| 目的：颈前路椎管减压术是治疗颈椎病的重要方法，但术后少数患者发生邻近融合节段的退行性变，甚至需要二次手术治
疗。本文旨在分析术后再次退变的原因，以期为广大外科医师提供参考。方法：报道1 例该病再次手术的患者，回顾其疾病发展过
程和治疗经过，并结合该病例综述国内外相关文献，深入探讨术后复发原因。结果：颈前路椎管减压术后复发主要有三类原因：①
手术入路和手术方法的选择不恰当；②手术减压不充分，未能彻底解除潜在的颈髓压迫；③椎间融合后生物力学改变，相应颈椎
节段应力不平衡。结论：对于需再次手术的患者，术前应仔细分析上次手术效果不佳或术后复发的原因，妥善选择再手术的方式。 |
| 英文摘要: |
| Objective:Spinal canal anterior decompression is an important treatment for cervical spondylosis. However, a few patients
have adjacent segment degeneration after surgery, thus leading to corresponding neurological symptoms and second operation. This
article aims to analyze potential reasons and to provide a reference for surgeons.Methods:One case who were underwent the second
spinal canal anterior decompression were reported here. We reviewed the medical history and treatment course. Aditionally we extensively
reviewed relative literatures to deeply discuss the potential reasons.Results:There are three possible mechanisms for postoperative
re-compression. Firstly, the surgical approaches may be improper. Secondly, the decompression may be insufficient, failing to completely
or definitively decompress the spinal cord. Thirdly, the biomechanics of adjacent segmental cervical vertebras may change after cervical
fusion.Conclusion:For postoperative recurrent patients, carefully evaluating recurrent reasons are of vital importance to the treatment
plan decision. |
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