北京大学医学部机构知识库
Advanced  
IR@PKUHSC  > 北京大学第三临床医学院  > 骨科  > 期刊论文
学科主题: 临床医学
题名:
Different Approaches for Treating Multilevel Cervical Spondylotic Myelopathy: A Retrospective Study of 153 Cases from a Single Spinal Center
作者: Li, Xiumao1; Jiang, Liang1; Liu, Zhongjun1; Liu, Xiaoguang1; Zhang, Hua2; Zhou, Hua1; Wei, Feng1; Yu, Miao1; Wu, Fengliang1
刊名: PLOS ONE
发表日期: 2015-10-13
DOI: 10.1371/journal.pone.0140031
卷: 10, 期:10
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Multidisciplinary Sciences
研究领域[WOS]: Science & Technology - Other Topics
关键词[WOS]: POSTERIOR LONGITUDINAL LIGAMENT ; SURGICAL-TREATMENT ; ANTERIOR ; DECOMPRESSION ; LAMINOPLASTY ; COMPRESSION ; OUTCOMES ; FUSION ; RATIO ; CORD
英文摘要:

Objective

The optimal surgical treatment for multilevel cervical spondylotic myelopathy (MCSM) remains controversial. This study compared the outcomes of three surgical approaches for MSCM treatment, focusing on the efficacy and safety of a combined approach.

Methods

This retrospective study included 153 consecutive MCSM patients (100 men, 53 women; mean age +/- standard deviation, 55.7 +/- 9.4 years) undergoing operations involving >= 3 intervertebral segments. The patients were divided into three groups according to surgical approach: anterior (n = 19), posterior (n = 76), and combined (n = 58). We assessed demographic variables, perioperative parameters, and clinical outcomes >= 12 months after surgery (20.5 +/- 7.6 months), including Japanese Orthopaedic Association (JOA) score, improvement, recovery rate, and complications.

Results

The anterior group had the most favorable preoperative conditions, including the highest preoperative JOA score (12.95 +/- 1.86, rho = 0.046). In contrast, the combined group had the highest occupancy ratio (48.0% +/- 11.6%, rho = 0.002). All groups showed significant neurological improvement at final follow-ups, with JOA recovery rates of 59.7%, 54.6%, and 68.9% in the anterior, posterior, and combined groups, respectively (rho = 0.163). After multi-variable adjustments, the groups did not have significantly different clinical outcomes (postoperative JOA score, rho = 0.424; improvement, rho = 0.424; recovery rate, rho = 0.080). Further, subgroup analyses of patients with occupancy ratios >= 50% showed similar functional outcomes following the posterior and combined approaches. Overall complication rates did not differ significantly among the three approaches (rho = 0.600). Occupancy ratios did not have a significant negative influence on postoperative recovery following the posterior approach.

Conclusions

If applied appropriately, all three approaches are effective for treating MCSM. All three approaches had equivalent neurological outcomes, even in subgroups with high occupancy ratios. Further investigations of surgical approaches to MCSM are needed, particularly prospective multicenter studies with long-term follow-up.

语种: 英语
所属项目编号: AOSCN (R) 2013-07
项目资助者: AOSpine China Research Grant Project
WOS记录号: WOS:000362962300049
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/51201
Appears in Collections:北京大学第三临床医学院_骨科_期刊论文

Files in This Item:

There are no files associated with this item.


作者单位: 1.Peking Univ, Hosp 3, Dept Orthopaed, Beijing 100191, Peoples R China
2.Peking Univ, Hosp 3, Res Ctr Clin Epidemiol, Beijing 100191, Peoples R China

Recommended Citation:
Li, Xiumao,Jiang, Liang,Liu, Zhongjun,et al. Different Approaches for Treating Multilevel Cervical Spondylotic Myelopathy: A Retrospective Study of 153 Cases from a Single Spinal Center[J]. PLOS ONE,2015,10(10).
Service
Recommend this item
Sava as my favorate item
Show this item's statistics
Export Endnote File
Google Scholar
Similar articles in Google Scholar
[Li, Xiumao]'s Articles
[Jiang, Liang]'s Articles
[Liu, Zhongjun]'s Articles
CSDL cross search
Similar articles in CSDL Cross Search
[Li, Xiumao]‘s Articles
[Jiang, Liang]‘s Articles
[Liu, Zhongjun]‘s Articles
Related Copyright Policies
Null
Social Bookmarking
Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit

Items in IR are protected by copyright, with all rights reserved, unless otherwise indicated.

 

 

Valid XHTML 1.0!
Copyright © 2007-2017  北京大学医学部 - Feedback
Powered by CSpace