POSTERIOR DYNAMIC/SEMI-RIGID STABILIZATION AS AN EFFECTIVE TREATMENT FOR CERVICAL SPINAL STENOSIS.

Kemal Paksoy, İdris Avci, Salim Şentürk, Onur Yaman, Ali Fahir Özer
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Abstract

Aim: We investigated the short- term results of dynamic/semi-rigid stabilization in patients with cervi-cal spinal stenosis and compare them with patients for which decompression and posterior cer-vical fusion was performed.

Material and methods: 28 patients were included in this study. Group 1 was the semi-rigid group (four male, ten fe-male), group 2 was the fusion group (nine male, five female). We compared the clinical status of the patients pre-operatively, first and twelfth month post-operatively using the Visual Analog Scale (VAS) and Neck Disability Index (NDI). Also radiologically, the pre-operative and on the postoperative first and twelfth month, cervical sagittal vertical axis (cSVA), cervical lordosis (C0-2) (C2-7) and T1 slope were measured.

Results: Our results showed that there was a significant improvement on the VAS and NDI score after semi-rigid and fusion surgery (p 0.001). Also, the cervical lordosis was obtained in both groups (p = 0.033). Although, no significant differences was found between both groups re-garding the change of variables over time between post-operative first and twelfth month.

Conclusion: Although, posterior dynamic stabilization has been previously used in thoracic and lumbar pa-thologies before, there is no crucial evidence about their effects in cervical stenosis. This study states, that semi-rigid instrumentation is as effective in clinical and radiologic outcomes as pos-terior fusion surgery in periods of one year. Also, the lower risk of adjacent-segment disease and pseudoarthrosis and preservation of cervical sagittal alignment are the main advantages of the new method.

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后路动态/半刚性稳定作为治疗颈椎管狭窄的有效方法。
目的:我们研究了颈椎管狭窄患者动态/半刚性稳定的短期效果,并将其与减压和后路颈椎融合的患者进行比较。材料和方法:本研究纳入28例患者。组1为半刚性组(男性4例,fe-male 10例),组2为融合组(男性9例,女性5例)。我们采用视觉模拟评分(VAS)和颈部残疾指数(NDI)比较患者术前、术后1个月和12个月的临床状况。放射学上,术前和术后第1个月和第12个月,测量颈椎矢状垂直轴(cSVA),颈椎前凸(c2 -2) (C2-7)和T1斜率。结果:我们的结果显示,半刚性和融合手术后VAS和NDI评分有显著改善(p < 0.001)。两组均出现颈椎前凸(p = 0.033)。然而,两组在术后第1个月和第12个月的变量变化方面没有发现显著差异。结论:虽然后路动力稳定术以前曾用于胸椎和腰椎病变,但没有关于其在颈椎狭窄中的作用的关键证据。这项研究表明,在一年的时间里,半刚性内固定在临床和放射学结果上与后路融合手术一样有效。此外,低风险的邻接节段疾病和假关节和保存颈椎矢状线是新方法的主要优点。
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