颈前路减压融合手术对颈椎矢状位形态的影响

Effect of anterior cervical decompression and fusion on the sagittal cervical balance

[目的]探讨颈前路减压手术对颈椎矢状位形态的影响。[方法]回顾性分析2019年5月—2020年3月在本院行颈前路减压融合术(anterior cervical decompression and fusion,ACDF)治疗退行性颈椎病且有完整随访资料116例患者的临床资料。比较术前及末次随访时,VAS、JOA和NDI评分,以影像矢状位平衡参数的变化。[结果]所有患者手术顺利完成,术中无严重并发症。随访12~15个月,平均(13.52±1.43)个月。与术前相比,末次随访时VAS和NDI评分显著降低(P<0.05),而JOA评分显著增加(P<0.05)。影像方面,与术前相比,末次随访时C_(2-7) SVA减小,但差异无统计学意义(P>0.05);C_(2-7) Cobb角和椎间隙高度均显著增加(P<0.05)。[结论]颈前路减压融合手术可以直接解除脊髓、神经的压迫,并改善颈椎矢状位平衡。

[Objective]To explore the effect of anterior cervical decompression and fusion(ACDF)on the sagittal cervical balance.[Methods]A retrospective study was conducted on a total of 116 patients who underwent ACDF for degenerative cervical spondylosis in our hospital from May 2019 to March 2020 with complete follow-up data.The VAS,JOA,and NDI scores,as well as sagittal cervical balance parameters measured on radiographs were compared before surgery and at the last follow-up to determine the changes.[Results]All patients were successfully operated on without serious complications.The patients were followed up for 12 to 15 months,with a mean of(13.52±1.43)months.The VAS and NDI scores significantly declined(P<0.05),while the JOA score significantly increased at the latest follow up compared with those preoperatively(P<0.05).In terms of imaging assessment,the C_(2-7)SV A at the last follow-up decreased compared with that before surgery,but the difference was not statistically significant(P>0.05),whereas the C_(2-7)Cobb angle and intervertebral space height significantly increased(P<0.05).[Conclusion]Anterior cervical decompression and fusion not only relieve the compression of spinal cord and nerves directly,but also improve the sagittal balance of cervical spine.