Radiological Examination of Postoperative Cervical Alignment and Stability in Patients with Dialysis-Associated Spondylosis Excluding Destructive Spondyloarthropathy: Comparison with Patients with Cervical Spondylotic Myelopathy
| Autor: | Yasuharu Nakashima, Seiji Okada, Yasumasa Ito, Mitsumasa Hayashida, Tatsuya Yufu, Hirokazu Saiwai, Satoshi Baba, Akinobu Matsushita, Kenichi Seo, Shinji Tomari, Kenichi Kawaguchi, Takahiro Yasuhara, Yoshihiro Matsumoto |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment lcsh:Surgery Kyphosis destructive spondyloarthropathy Spondylotic myelopathy medicine laminoplasty Orthopedics and Sports Medicine In patient Dialysis cervical spondylotic myelopathy Destructive spondyloarthropathy business.industry lcsh:RD1-811 Dialysis-associated spondylosis Radiological examination Laminoplasty medicine.disease Sagittal plane Surgery medicine.anatomical_structure Original Article Neurology (clinical) business |
| Zdroj: | Spine Surgery and Related Research Spine Surgery and Related Research, Vol 2, Iss 3, Pp 202-209 (2018) |
| ISSN: | 2432-261X |
| DOI: | 10.22603/ssrr.2017-0068 |
| Popis: | Introduction Several reports have demonstrated the surgical treatment strategy for patients with dialysis-associated spondylosis in the cervical spine (CDAS) with destructive spondyloarthropathy (DSA). However, studies focusing on the clinical outcome of patients with CDAS without DSA remain scarce. We aimed to review the treatment strategy of patients with CDAS but without DSA. Methods The clinical data and surgical records of consecutive patients with CDAS without DSA (n = 9; D-group) and cervical spondylotic myelopathy (CSM) (n = 30; C-group) who underwent modified double-door laminoplasty(DDL) were reviewed retrospectively. We investigated four radiologic factors in the pre-and postoperative periods that have been reported to be the risk factors for worsening of clinical symptoms in various studies and examined statistical comparison between the D and C groups. Results In the D group, the pre- versus postoperative C2-C7 sagittal angles were not significantly different, and only two patients (22%) had kyphosis postoperatively. There was a significant difference in the pre- and postoperative C2-C7 angles in the two groups (P = 0.031). Regarding the change in segmental alignment, the local open angle increased at the C4/C5 level in the D group. Also there was a significant difference in the local angles between the two groups at C4/5 and C5/6 (P = 0.00038, and 0.037), suggesting that postoperative segmental mobility at C4/5 and C5/6 was higher in the D group than in the C group. Conclusions In the present study, DDL in patients with CDAS without DSA did not adversely affect the postoperative alignment and stability compared with CSM patients with CSM. However, patients in the D group may have a chance to develop DSA change at the C4/5 level in the future, and careful long-term follow-up is warranted. |
| Databáze: | OpenAIRE |
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