体质量指数与围手术期颈椎后路单开门椎管成形术后轴性症状相关性研究

Study on the correlation between body mass index and axial symptoms after perioperative cervical posterior single open-door laminoplasty

目的探讨体质量指数(BMI)与围手术期颈椎后路单开门椎管成型术术后轴性症状之间的关系。方法回顾性分析2020年1—9月于郑州大学第一附属医院骨科接受颈后路单开门椎管扩大成形术的66例患者的资料,记录身高体重并计算BMI,按体重标准分为两组:超重组(BMI≥23.9 kg/m^(2))30例;体重正常组(BMI<23.9 kg/m^(2))36例。比较两组术中出血量、手术时间、术后住院时间、术后1、3、7 d有关颈部疼痛的VAS评分,术前、术后1个月和3个月时的日本骨科协会(JOA)评分,颈椎曲度。结果两组患者术中出血比较,差异无统计学意义(P>0.05),手术时间超重组大于正常组(t=-3.124,P<0.05),超重组术后1、3 d VAS评分高于正常组(t=10.780,P<0.05;t=9.237,P<0.05),术前、术后7 d VAS评分比较,差异无统计学意义(t=0.347,P>0.05;t=1.646,P>0.05)。两组间术前、术后1、3个月JOA评分比较,差异无统计学意义(P>0.05)、两组间术前、术后1个月Cobb角比较,差异无统计学意义(t=0.972、P>0.05;t=0.318、P>0.05),两组术后1个月Cobb角均较术前减小(t=7.453、P<0.05;t=14.883、P<0.05)。结论颈椎后路单开门椎管扩大成形术后,超重组与正常组手术疗效相当,但前者手术时间更长,术后围手术期轴性症状更重。

Objective To explore the relationship between body mass index(BMI)and axial symptoms after perioperative cervical posterior single open-door laminoplasty.Methods The data of 66 patients who underwent posterior single open-door expansive laminoplasty in the Department of Orthopedics of the First Affiliated Hospital of Zhengzhou University from January to September 2020 were retrospectively analyzed.Their height and weight were recorded and BMI was calculated.They were divided into two groups according to the weight standard:30 cases in the overweight group(BMI≥23.9 kg/m^(2))and 36 cases in the normal weight group(BMI<23.9 kg/m^(2)).The amount of intraoperative bleeding,operation time,postoperative hospital stay,visual analog scale(VAS)score related to neck pain on Days 1,3 and 7 after operation,Japanese Orthopedic Association(JOA)score before operation,1 month and 3 months after operation and cervical curvature were compared between the two groups.Results There were no statistical differences in intraoperative bleeding between the two groups of patients(P>0.05).The operation time of the overweight group was longer than that of the normal weight group(t=-3.124,P<0.05).The VAS score on postoperative Days 1 and 3 of the overweight group was higher than that of the normal weight group(t=10.780,P<0.05;t=9.237,P<0.05).There was no statistical difference in VAS score before operation and 7 days after operation between the two groups(t=0.347,P>0.05;t=1.646,P>0.05).There was no statistical difference in JOA score before operation,1 month and 3 months after operation between the two groups(P>0.05).There was no statistical difference in Cobb angle before operation and 1 month after operation between the two groups(t=0.972,P>0.05;t=0.318,P>0.05).Cobb angle in 1 month after operation decreased compared with that before operation(t=7.453,P<0.05;t=14.883,P<0.05).Conclusion After cervical posterior single open-door expansive laminoplasty,the surgical efficacy for the overweight group is equivalent to that for the normal weight group,but the operation time for the former is longer and the perioperative axial symptoms are more serious.