前路椎体骨化物复合体可控前移技术对颈椎后纵韧带骨化症患者功能恢复的影响

Effect of controlled anterior displacement of vertebral ossification complex on functional recovery of patients with ossification of posterior longitudinal ligament of cervical spine

目的 分析前路椎体骨化物复合体可控前移(ACAF)技术在颈椎后纵韧带骨化症(OPLL)患者中的效果。方法 选取2017年8月—2022年8月本院及上海长征医院收治的70例OPLL患者,按抽签法随机分为2组,每组各35例。对照组行后路单开门椎管成形术,实验组行ACAF技术,观察到术后6个月。对比2组手术相关指标、颈部疼痛程度、影像学参数、生活质量评分、并发症发生率等。结果 2组手术、住院时间相比,差异无统计学意义(P>0.05);实验组术中出血量少于对照组,差异有统计学意义(χ^(2)=25.140,P<0.001);2组术后VAS评分均低于术前,差异有统计学意义(t=8.548、9.064,P均<0.001);术后,实验组椎管矢状径、颈椎生理曲度、生活质量综合评定问卷(GQOLI-74)内各维度评分高于对照组,椎管狭窄率低于对照组,差异有统计学意义(t=4.409、4.451、28.381、13.088、12.019、8.455、7.505,P均<0.001);实验组并发症发生率低于对照组,差异有统计学意义(P=0.046)。结论 ACAF技术治疗OPLL患者效果明显,其手术创伤更小,可缓解患者疼痛,有效恢复颈椎生理曲度,脊髓原位减压,以此提高其生活质量,且并发症较少,值得临床推广。

Objective To analyze the effect of anterior controlled anterior displacement of vertebral ossification complex(ACAF)in patients with cervical ossification of posterior longitudinal ligament(OPLL).Methods A total of 70 OPLL patients admitted to The Third People’s Hospital of Jinan City,and Shanghai Changzheng Hospital from August 2017 to August 2022 were selected and randomly divided into two groups(a control group and an experimental group),with 35 pa⁃tients in each group.The control group underwent posterior single⁃door laminoplasty,while the experimental group under⁃went ACAF technique and they were observed for 6 months after surgery.The two groups were compared for surgical⁃related indicators,degree of neck pain,imaging parameters,quality of life,and complications.Results There was no statistically significant difference in the duration of surgery and hospitalization between the two groups(P>0.05).The intraoperative bleeding in the experimental group was less than that in the control group,and the difference was statistically significant(χ^(2)=25.140,P<0.001).The postoperative VAS scores of the two groups were lower than those before surgery,and the difference was statistically significant(t=8.548,9.064,both P<0.001).After surgery,the scores of various dimensions in the GQOLI-74 comprehensive evaluation questionnaire for spinal canal sagittal diameter,cervical physiological curvature,and quality of life in the experimental group were higher than those in the control group,and the rate of spinal canal stenosis was lower than that in the control group,with statistical significance(t=4.409,4.451,28.381,13.088,12.019,8.455,7.505,all P<0.001).The incidence of complications in the experimental group was lower than that in the control group,and the dif⁃ference was statistically significant(P=0.046).Conclusions ACAF technology has a significant therapeutic effect on OPLL patients,with less surgical trauma,relieving pain,effectively restoring cervical physiological curvature, and in⁃situ spinal cord decompression, thereby improving their quality oflife with fewer complications. It is worth vigorously promoting in clinical practice.