摘要
目的 对比颈椎前路两种术式的临床疗效及对颈椎矢状位平衡的影响.方法 回顾性分析2018 年1 月～2020 年1月在大理大学第一附属医院脊柱外科因颈椎病行颈前路手术的 53 例患者,将其分为两组,A组 25 例(行单节段ACCF术),B组28 例(行两相邻节段ACDF术),测量手术前及术后末次随访时颈椎侧位X线片上的相关参数,对以上数据进行统计学分析.结果 两组患者C2-7 Cobb角、手术节段 Cobb角(segment Cobb angle,SCobb)、C2-7 矢状位垂直距离(C2-7 sagittal vertical axis,C2-7 SVA)、T1 倾斜角(T1-Slope,T1 S)、颈倾斜角(neck tilt,NT)的手术前后组内比较,差异有统计学意义(P＜0.05);两组间比较,末次随访时的C2-7 SVA组间差异有统计学意义(P＜0.05),术前及末次随访时的T1S组间差异有统计学意义(P＜0.05);两组术前、术后末次随访时的组内VAS评分、NDI指数比较,差异有统计学意义(P＜0.05).相关性分析显示,C2-7 Cobb角与SCobb角(r=0.644,P＜0.05)和T1 S(r=0.417,P＜0.05)呈正相关,与C2-7 SVA(r=-0.493,P＜0.05)呈负相关.结论 ACCF和ACDF两种前路术式均通过改变矢状位平衡使颈椎病患者获得良好的临床疗效,两种术式对颈椎矢状位平衡的改变效果相似,C2-7 Cobb角与其他颈椎矢状位参数有相关性.
Abstract
Objective To compare the clinical efficacy of the two anterior cervical surgery methods and the effect on the sagittal balance of cervical spine.Methods A retrospective analysis was performed on the clinical data of 53 cases of cervical spondylosis patients admitted to the Department of Spine Surgery in our hospital from January,2018 to January,2020.There were 25 cases in Group A,who had an operation on single segment ACCFand 28 cases in Group B,who had an operation on two adjacent segments ACDF.The relevant parameters on lateral radiographs of cervical spine were measured before surgery and at the last follow-up after surgery,and the above data were statistically analyzed.Results There were statistically significant differences in C2-7 Cobb angle,SCobb,C2-7 SVA,T1S and NT between the two groups before and after surgery(P＜0.05).There was statistically significant difference in C2-7 SVA between the two groups at the last follow-up(P＜0.05),and there was statistically significant difference in T1s between the two groups before surgery and at the last follow-up(P＜0.05).There were statistically significant differences in VAS score and NDI index between the two groups in preoperative and final postoperative follow-up(P＜0.05).C2-7 Cobb angle was positively correlated with SCobb angle(r=0.644,P＜0.05)and T1S(r=0.417,P＜0.05),and negatively correlated with C2-7 SVA(r=-0.493,P＜0.05).Conclusion Both ACCF and ACDF anterior surgery methods can achieve good clinical efficacy in patients with cervical spondylosis by changing sagittal balance.The alteration effect of both methods on cervical sagittal balance is similar,and C2-7 Cobb angle is correlated with other cervical sagittal parameters.
基金项目
云南省教育厅科学研究基金(2021J0388)
云南省教育厅科学研究基金(2023J0904)
大理大学第一附属医院学科建设骨干项目(DFYGG2022-28)
NETL
NSTL
维普
万方数据