دورية أكاديمية

Comparison of Outcomes in 3 Surgical Approaches for Dystrophic Cervical Kyphosis in Patients with Neurofibromatosis 1.

التفاصيل البيبلوغرافية
العنوان: Comparison of Outcomes in 3 Surgical Approaches for Dystrophic Cervical Kyphosis in Patients with Neurofibromatosis 1.
المؤلفون: Lin, Tao1, Shao, Wei1, Zhang, Ke1, Gao, Rui1 rgaospine@163.com, Zhou, Xuhui1 xhzhouspine@163.com
المصدر: World Neurosurgery. Mar2018, Vol. 111, pe62-e71. 1p.
مصطلحات موضوعية: *SURGERY, *KYPHOSIS, *NEUROFIBROMATOSIS 1, *SURGICAL complications, *SPINE abnormalities, *PATIENTS, *THERAPEUTICS
مستخلص: Objective To compare outcomes of anterior-only (AO), posterior-only (PO), and anteroposterior (AP) surgical approaches for treatment of dystrophic cervical kyphosis in patients with neurofibromatosis 1 (NF1). Methods This retrospective observational study included 81 patients with dystrophic cervical kyphosis secondary to NF1. Length of kyphosis, duration of halo traction, Cobb angle, C2-7–sagittal vertical axis (SVA), T1 slope, Neck Disability Index score, and postoperative complications were evaluated before and, if possible, after each surgical approach. Results AP approach provided the best outcomes (average spinal Cobb angle was corrected from 61.2 ± 9.1° to 5.7 ± 3.2°, P < 0.05); there was no significant difference between AO and PO approaches ( P > 0.05). With regard to cervical sagittal balance, AP approach had the most improvements of C2-7–SVA (mean C2-7–SVA was corrected from 3.2 ± 9.2 mm to 12.8 ± 2.6 mm, P < 0.05); the difference between AO and PO approaches was not significant ( P > 0.05). T1 slope results were similar to C2-7–SVA. Neck Disability Index score of all patients improved significantly after surgery ( P < 0.05); specifically, patients who had an AP approach constituted the largest portion of the satisfied patient group. Postoperative junctional kyphosis occurred in 11 patients (1 AP approach, 6 AO approach, 4 PO approach); these findings correlated with patients with ≤5 fused segments. Conclusions AP approach surgery provided the best correction of dystrophic cervical kyphosis and sagittal balance for patients with NF1. Patients undergoing an AP approach were more satisfied with their outcomes. Junctional kyphosis can be prevented effectively using an AP approach in patients with >5 fused segments. [ABSTRACT FROM AUTHOR]
قاعدة البيانات: Academic Search Index
الوصف
تدمد:18788750
DOI:10.1016/j.wneu.2017.11.174