Long-term outcome of the Cloward procedure for single-level cervical degenerative spondylosis. Clinical and radiological assessment after a 22-year mean follow-up

被引:10
作者
Noriega, D. C. [1 ]
Kreuger, A. [2 ]
Brotat, M. [1 ]
Ardura, F. [1 ]
Hernandez, R. [1 ]
Munoz, M. F. [1 ]
Barrios, C. [3 ]
机构
[1] Univ Hosp Valladolid, Dept Orthoped Surg, Valladolid 47006, Spain
[2] Marburg Univ Hosp, Dept Trauma & Reconstruct Surg, Marburg, Germany
[3] Valencia Catholic Univ, Inst Res Musculoskeletal Disorders, Valencia, Spain
关键词
Cervical spondylosis; Cloward procedure; Cervical sagittal balance; CARBON-FIBER CAGE; INTERBODY FUSION; DISC HERNIATION; DISKECTOMY; SPINE; ADJACENT; REMOVAL;
D O I
10.1007/s00701-013-1902-y
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
To evaluate the long-term outcomes of the classical Cloward procedure in single-level cervical spondylosis. A retrospective study of 28 patients who were affected by cervical degenerative spondylosis at C4-C7 segments and treated by the Cloward technique at a single level from 1985-1995 was conducted. The average follow-up period was 22 years (range, 17-27 years). Preoperative clinical complaints were recorded and compared to the current clinical status. Preoperative, 3-6 months postoperative and a current radiographic study were analysed by evaluating the segmental and global sagittal alignment of the cervical spine as well as the occurrence of adjacent disc degeneration. The most frequently operated segment was C5-C6 (57.1 %), followed by C6-C7 (32.1 %) and C4-C5 (7.1 %). Pain relief and symptom recovery experienced 3-6 months following the surgery was maintained at the most recent follow-up in 85 % of patients. Adjacent disc degeneration was detected in a total of 17 cases (60.7 %). Overall, a group of 14 cases (50 %) had increased lordosis at C2-C7 at the most recent follow-up, with a mean gain of 1.5A(0) Cobb. According to Odom's criteria, 17 patients (60.8 %) presented with excellent clinical outcome, 6 (21.4 %) presented with good outcome, 5 had a (17.8 %) fair outcome, and none had a poor outcome. The Cloward technique provided excellent long-term clinical outcome in the treatment of single-level cervical degenerative spondylosis. There were no major alterations of the cervical sagittal balance, and the development of adjacent segment disease (ASD) was not specifically associated with the previous surgery.
引用
收藏
页码:2339 / 2344
页数:6
相关论文
共 25 条
  • [1] Outcome analysis of noninstrumented anterior cervical discectomy and interbody fusion in 348 patients
    Cauthen, JC
    Kinard, RE
    Vogler, JB
    Jackson, DE
    DePaz, OB
    Hunter, OL
    Wasserburger, LB
    Williams, VM
    [J]. SPINE, 1998, 23 (02) : 188 - 192
  • [2] THE ANTERIOR APPROACH FOR REMOVAL OF RUPTURED CERVICAL DISKS
    CLOWARD, RB
    [J]. JOURNAL OF NEUROSURGERY, 1958, 15 (06) : 602 - 617
  • [3] CLOWARD RB, 1971, SURGERY, V69, P175
  • [4] THE ANTERIOR SURGICAL APPROACH TO THE CERVICAL-SPINE - THE CLOWARD PROCEDURE - PAST, PRESENT, AND FUTURE - THE PRESIDENTIAL GUEST LECTURE, CERVICAL-SPINE RESEARCH SOCIETY
    CLOWARD, RB
    [J]. SPINE, 1988, 13 (07) : 823 - 827
  • [5] Sagittal Segmental Alignment as Predictor of Adjacent-Level Degeneration After a Cloward Procedure
    Faldini, Cesare
    Pagkrati, Stavroula
    Leonetti, Danilo
    Miscione, Maria Teresa
    Giannini, Sandro
    [J]. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2011, 469 (03) : 674 - 681
  • [6] Cervical disc herniation and cervical spondylosis surgically treated by Cloward procedure: A 10-year-minimum follow-up study
    Faldini C.
    Leonetti D.
    Nanni M.
    Martino A.D.
    Denaro L.
    Denaro V.
    Giannini S.
    [J]. Journal of Orthopaedics and Traumatology, 2010, 11 (2) : 99 - 103
  • [7] Surgical management of cervical degenerative disease: the evidence related to indications, impact, and outcome
    Fehlings, Michael G.
    Arvin, Babak
    [J]. JOURNAL OF NEUROSURGERY-SPINE, 2009, 11 (02) : 97 - 100
  • [8] Long-term follow-up results of the Cloward procedure for cervical spondylotic myelopathy
    Galasso, Olimpio
    Mariconda, Massimo
    Ianno, Bruno
    De Gori, Marco
    Gasparini, Giorgio
    [J]. EUROPEAN SPINE JOURNAL, 2013, 22 (01) : 128 - 134
  • [9] Operative Outcomes for Cervical Myelopathy and Radiculopathy
    Galbraith, J. G.
    Butler, J. S.
    Dolan, A. M.
    O'Byrne, J. M.
    [J]. ADVANCES IN ORTHOPEDICS, 2012, 2012
  • [10] Goldschlager T, 2009, JOVE-J VIS EXP, V32, P1548