摘要
目的探讨矢状位参数在颈椎前路椎间盘切除减压植骨融合术治疗3节段脊髓型颈椎病中的价值。方法采用颈椎前路椎间盘切除减压植骨融合术(ACDF)治疗36例3节段脊髓型颈椎病患者。比较手术前后手术节段角度(SA)、C_(2~7)Cobb角、C_(2~7)矢状位轴向距离(C_(2~7)SVA)和T_(1)倾斜角(T_(1)S),分析手术前后颈椎矢状位参数间及其与颈椎JOA评分的相关性。结果患者均获得随访,时间6~24(12.59±10.21)个月。T_(1)S、C_(2~7)Cobb角、SA、JOA评分术后均较术前明显增加(P<0.05)。C_(2~7)SVA术前与术后比较差异无统计学意义(P>0.05)。手术前后T_(1)S、C_(2~7)Cobb角、SA、JOA评分相互呈正相关关系(P<0.05)。术前C_(2~7)SVA与术前T_(1)S、C_(2~7)Cobb角、SA、JOA评分无相关关系(P>0.05)。术后C_(2~7)SVA与术后C_(2~7)Cobb角、SA、JOA评分呈负相关关系(P<0.05)。术前与术后颈椎矢状位参数间变化量的相关性分析显示,ΔT_(1)S、ΔC_(2~7)Cobb角、ΔSA与ΔJOA评分相互呈正相关关系(P<0.05),ΔC_(2~7)SVA值与ΔC_(2~7)Cobb角、ΔSA、ΔJOA评分呈负相关关系(P<0.05)。结论ACDF治疗3节段脊髓型颈椎病疗效显著,并且可以加强颈椎各矢状位参数之间的相关性,最终达到恢复颈椎矢状位参数平衡的目的。
Objective To investigate the value of sagittal parameters in anterior cervical discectomy decompression and fusion(ACDF)with bone grafting for treatment of three-segment cervical spondylotic myelopathy(CSM).Methods The 36 patients with three-segment CSM were treated by ACDF with bone grafting.The segmental angle(SA),C_(2~7) Cobb angle,C_(2~7) sagittal vertical axis(C_(2~7) SVA)and T_(1) slope(T_(1)S)were compared before and after operation,and the correlation between cervical sagittal parameters and cervical JOA score was analyzed.Results All patients were followed up for 6~24(12.59±10.21)months.T_(1)S,C_(2~7) Cobb angle,SA and JOA scores were significantly increased than the preoperation(P<0.05).C_(2~7) SVA had no statistical difference with the preoperation(P>0.05).There were mutual positive correlation for T_(1)S,C_(2~7) Cobb angle and SA,JOA score between the preopeation and postoperation(P<0.05).At the preoperation,C_(2~7) SVA was not correlated with preoperative T_(1)S,C_(2~7) Cobb angle,SA,JOA score(P>0.05),while at the postoperation,C_(2~7) SVA was negatively correlated with postoperative C_(2~7) Cobb angle,SA,JOA score(P>0.05).The correlation analysis of the changes of cervical sagittal parameters at the preoperative and postoperative showed thatΔT_(1)S,ΔC_(2~7) Cobb angle,ΔSA andΔJOA score were positively correlated mutually(P<0.05),and the value ofΔC_(2~7) SVA was negatively correlated withΔC_(2~7) Cobb angle,ΔSA andΔJOA score(P<0.05).Conclusions ACDF is effective in the treatment of three-segment CSM,and can strengthen the correlation among the sagittal parameters of cervical spine,and finally achieve the goal of restoring the balance of cervical sagittal parameters.
作者
赵学千
贾象元
李晋玉
陈江
袁林
马慧
孙飞飞
贾育松
ZHAO Xue-qian;JIA Xiang-yuan;LI Jin-yu;CHEN Jiang;YUAN Lin;MA Hui;SUN Fei-fei;JIA Yu-song(SectionⅠ,Dept of Orthopaedics and Traumatology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Dept of Orthopaedics,the Second Affiliated Hospital,Tsinghua University,Tsinghua University Hospital of Integrated Chinese and Western Medicine,Beijing 100040,China;不详)
出处
《临床骨科杂志》
2022年第1期1-6,共6页
Journal of Clinical Orthopaedics
基金
北京中医药大学横向课题(编号:HX-DZM-2017001)。
关键词
3节段脊髓型颈椎病
颈前路减压椎间融合术
矢状位参数
three-segment cervical spondylotic myelopathy
antererior cervical discectomy and fusion
sagittal parameters