颈椎矢状位序列参数在评估颈前路椎间盘切除融合术疗效中的价值

The value of cervical spine sagittal sequence parameters in evaluating the efficacy of anterior cervical discectomy and fusion

目的探讨颈椎矢状位序列参数在评估颈前路椎间盘切除融合术(ACDF)疗效中的价值。方法采用ACDF治疗84例脊髓型颈椎病患者。比较手术前后疼痛VAS评分、JOA评分、颈椎功能障碍指数(NDI);根据手术前后颈椎X线片矢状位测量矢状位轴向距离(SVA)、T1倾斜角(T1S)、颈椎前凸角。结果患者均获1年随访。SVA、颈椎前凸角、T1S、JOA评分术后1年均较术前显著增加(升高),NDI、VAS评分术后1年均较术前显著降低,差异均有统计学意义(P<0.01)。术前颈椎前凸角与术后1年JOA评分呈正相关,与术后1年VAS评分呈负相关;术后1年,颈椎前凸角与VAS评分呈负相关,SVA与JOA评分呈正相关。结论ACDF治疗脊髓型颈椎病疗效显著,颈椎矢状位序列参数与颈椎功能及颈肩痛的改善有一定关系。

Objective To explore the value of cervical spine sagittal sequence parameters in evaluating the efficacy of anterior cervical discectomy and fusion(ACDF).Methods Eighty-four patients with cervical spondylotic myelopathy(CSM)were treated with ACDF.The pain VAS,JOA score,neck disability index(NDI)at the preoperaiton and postoperation were compared.The following data were measusred on the sagittal X-ray film of the cervical spine before and after the operation,including sagittal axial distance(SVA),T1 tilt angle(T1S),cervical lordosis angle.Results All patients were followed up for 1 year.At 1 year postoperation,SVA,cervical lordosis angle,T1S,and JOA scores were significantly increased than before surgery,and NDI and VAS were significantly decreased than those before surgery,and the differences were statistically significant(P<0.01).The preoperative cervical lordosis angle was positively correlated with the JOA score of postoperative 1 year and negatively correlated with VAS of the postoperative 1 year;at 1 year postoperation,the cervical lordosis angle was negatively correlated with VAS and SVA was positively correlated with JOA score(P<0.05).Conclusions ACDF has significant effect in the treatment of CSM.The cervical sagittal sequence parameters have a certain relationship with the improvement of postoperative vertebral function and neck and shoulder pain.