Changes of C7 slope,C2-C7 SVA and cervical lordosis before and after posterior cervical spondyloplasty in patients with cervical degenerative diseases and their significance
Objective To observe the changes of cervical dynamic position sagittal parameters[C7 slope(C7S),C2-C7 sagittal vertical axis(C2-C7 SVA)and cervical lordosis(CL)]before and after posterior cervical spondyloplasty in patients with cervical degenerative diseases,and to analyze the relationships between preoperative cervical dynamic posi-tion sagittal parameters and the curative effect of posterior cervical spondyloplasty in the treatment of cervical degenerative diseases,so as to provide a new reference index for curative effect prediction.Methods Forty-four patients with cervical degenerative diseases who underwent posterior cervical spondyloplasty and completed long-term follow-up were included.Cervical radiographs were performed before surgery,3 months after surgery and at the last follow-up to measure sagittal pa-rameters of neutral and dynamic positions[C7S,ratio of C2-C7 SVA value to C4 vertebral anteroposterior diameter(rS-VA)and CL]were compared.Spinal cord function(JOA score),cervical spine function evaluation(NDI score)were per-formed,and postoperative complications(axial symptoms,C5 nerve root paralysis,nerve function deterioration)were sta-tistically analyzed and compared.The patients were divided into the high value group and low value group according to the median values of sagittal parameters of dynamic position measured in cervical radiographs and changes before and after sur-gery.JOA score and NDI score before and after operation were compared between the high value group and low value group.Results At the last follow-up,the cervical neutral sagittal parameter CL had no significant change,but rSVA and C7S increased;the cervical dynamic position sagittal parameters CL decreased,rSVA and C7S increased.Compared with the preoperative results,JOA scores were higher and NDI scores were lower in patients with cervical degenerative dis-eases at 3 months after surgery and at the last follow-up(t:-8.124,-7.089,3.084,2.551,respectively;all P<0.05).Axial symptoms occurred in 22 cases(50%)after surgery,and C5 nerve root paralysis occurred in 5 cases(11.36%).Patients with smaller pre-operative hyperflexion CL,larger pre-operative hyperextension CL,smaller pre-opera-tive rSVA,and larger post-operative CL and rSVA had higher post-operative JOA scores and lower NDI scores(all P<0.05).Compared with patients without axial symptoms,patients with axial symptoms had lower pre-operative neutral C7S,pre-operative hyperextension CL and pre-operative hyperextension C7S(all P<0.05).Conclusions In patients with cervical degenerative diseases,the cervical dynamic position sagittal parameters CL was lower,rSVA and C7S were higher.Pre-operative sagittal parameters of cervical dynamic position may be related to the recovery of spinal cord function and cervical function after posterior cervical spondyloplasty and the occurrence of some complications in patients with cervi-cal degenerative diseases.
万方数据
维普
