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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2019.1
- 수록면
- 563 - 573 (11page)
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초록· 키워드
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Objective: Cervical disc replacement (CDR) is an effective long-term treatment for both cervical radiculopathy and myelopathy. However, there may be unique differences in the early postoperative clinical improvement for patients with and without myelopathy. In addition, previous studies using CDR to treat cervical myelopathy were underpowered to determine risk factors for relatively postoperative medical complications. Methods: Two different cohorts were studied. A local cohort of patients undergoing CDR by a single surgeon was utilized to study the early postoperative course of clinical improvement. In addition, a national cohort of patients undergoing CDR in the 2015 and 2016 National Surgical Quality Improvement Program database was utilized to study differences in postoperative medical complications after CDR. Patients with a preoperative diagnosis of cervical myelopathy were identified in both cohorts, and perioperative outcomes and complications were compared to patients without myelopathy. Results: A total of 43 patients undergoing CDR were included in the institutional cohort, of those 16 patients (37% of cohort) had a preoperative diagnosis of cervical myelopathy. A total of 3,023 patients undergoing CDR were included in the national cohort, of those 411 (13% of cohort) had a preoperative diagnosis of cervical myelopathy. In the institutional cohort, the nonmyelopathy group had a lower initial Neck Disability Index (NDI) and saw a faster improvement in NDI by 2 weeks postoperative. However, at 24 weeks there was no significant difference between groups in terms of NDI. Interestingly, only the nonmyelopathy cohort had a significant improvement in modified Japanese Orthopaedic Association score by 6 weeks (p<0.05). In the national cohort, myelopathy was associated with longer operative time and length of stay (p<0.05). However, there was no significant difference in perioperative complications (p>0.05) between myelopathy and nonmyelopathy patients. Conclusion: Significant improvements in NDI, visual analogue scale (VAS)-arm pain, and VAS-neck pain are seen in both myelopathy and nonmyelopathy populations undergoing CDR by 6 weeks postoperatively. However, nonmyelopathy populations improve faster by 2 weeks postoperatively. In the national cohort analysis, medical complications were similarly low in both myelopathy and nonmyelopathy groups.
목차
등록된 정보가 없습니다.
참고문헌 (28)
참고문헌 신청
Miller J / 2018 / Adjacent level degeneration : bryan total disc arthroplasty versus anterior cervical discectomy and fusion / Clin Spine Surg 31:E98~E101
Bono CM / 2011 / An evidence-based clinical guideline for the diagnosis and treatment of cervical radiculopathy from degenerative disorders / Spine J 11:64~72
Gornet MF / 2019 / Cervical disc arthroplasty:10-year outcomes of the Prestige LP cervical disc at a single level / J Neurosurg Spine :1~9
Gornet MF / 2019 / Two-level cervical disc arthroplasty versus anterior cervical discectomy and fusion: 10-year outcomes of a prospective, randomized investigational device exemption clinical trial / J Neurosurg Spine :1~11
Zou S / 2017 / Anterior cervical discectomy and fusion(ACDF)versus cervical disc arthroplasty(CDA)for two contiguous levels cervical disc degenerative disease : a meta-analysis of randomized controlled trials / Eur Spine J 26:985~997
Bono CM / 2011 / An evidence-based clinical guideline for the diagnosis and treatment of cervical radiculopathy from degenerative disorders / Spine J 11:64~72
Gornet MF / 2019 / Cervical disc arthroplasty:10-year outcomes of the Prestige LP cervical disc at a single level / J Neurosurg Spine :1~9
Gornet MF / 2019 / Two-level cervical disc arthroplasty versus anterior cervical discectomy and fusion: 10-year outcomes of a prospective, randomized investigational device exemption clinical trial / J Neurosurg Spine :1~11
Zou S / 2017 / Anterior cervical discectomy and fusion(ACDF)versus cervical disc arthroplasty(CDA)for two contiguous levels cervical disc degenerative disease : a meta-analysis of randomized controlled trials / Eur Spine J 26:985~997
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