颈椎后路单开门椎管扩大成形术对颈椎矢状平衡的影响

被引：10

作者：

孙钰岭

陈德玉

王新伟

陈宇

杨海松

机构：

[1] 长征医院脊柱外科

来源：

颈腰痛杂志 | 2016年 / 37卷 / 03期

关键词：

颈椎; 椎管成形术; 矢状平衡;

D O I：

暂无

中图分类号：

R687.3 [骨骼手术];

学科分类号：

100220 [骨科学];

摘要：

目的观察颈椎后路单开门椎管扩大成形术对颈椎矢状平衡的影响及各矢状平衡参数与临床恢复效果的相关性,探索可以预测术后疗效的平衡参数。方法回顾性分析2012-01-2013-04于长征医院脊柱外科行颈椎后路单开门椎管扩大成形术51例患者的影像学资料及临床资料,其中男性34例,女性17例,平均年龄52.8岁。比较术前、术后各矢状平衡参数及临床疗效指标的变化,探究各矢状平衡参数之间及其与临床恢复指标的相关性。结果随访时间为7-24个月,平均16.4个月。术前JOA评分平均8.9分,术后平均13.1分,平均神经功能改善率为51.8%。术前矢状平衡参数:C0-C2 Cobb角为（21.4±1.1）°,C2-C7 SVA为（25.3±1.2）mm,T1-Slope为（25.1±1.2）°;术后末次随访时:C0-C2 Cobb角为（24.2±1.0）°,C2-C7 SVA为（29.2±1.5）mm,T1-Slope为（28.5±1.4）°,三项参数术后较术前变化均有统计学意义。术前NDI、VAS及SF-36评分分别为（22.1±5.2）分、（2.9±1.2）分和（41.3±6.5）分;术后末次随访时以上评分分别为（11.7±5.1）分,（1.3±0.9）分,（52.4±6.8）分,三种评分术后较术前变化均有统计学意义。术后C0-C2 Cobb角增加值及术后T1-Slope增加值均与C2-C7 SVA增加值呈正相关,术前C2-C7 SVA与术后JOA评分呈负相关。结论颈椎后路单开门椎管成形术对于颈椎矢状平衡产生明显的影响,术后颈椎有发生前倾趋势。对于术前存在高C2-C7 SVA的患者,术后发生颈椎矢状平衡失衡的危险性增加,严重的颈椎矢状平衡失衡可导致患者颈部疼痛、功能障碍及生活质量下降。

引用

页码：191 / 195

页数：5

共 10 条

[1]

Postoperative Cervical Sagittal Imbalance Negatively Affects Outcomes After Surgery for Cervical Spondylotic Myelopathy [J].

Roguski, Marie ;

Benzel, Edward C. ;

Curran, Jill N. ;

Magge, Subu N. ;

Bisson, Erica F. ;

Krishnaney, Ajit A. ;

Steinmetz, Michael P. ;

Butler, William E. ;

Heary, Robert F. ;

Ghogawala, Zoher .

SPINE, 2014, 39 (25) :2070-2077

[2]

Does Preoperative T1 Slope Affect Radiological and Functional Outcomes After Cervical Laminoplasty? [J].

Cho, Jae Hwan ;

Ha, Jung-Ki ;

Kim, Dae Geun ;

Song, Keum-Young ;

Kim, Yung-Tae ;

Hwang, Chang Ju ;

Lee, Choon Sung ;

Lee, Dong-Ho .

SPINE, 2014, 39 (26) :E1575-E1581

[3]

Long-Term Results of Cervical Myelopathy Due to Ossifi cation of the Posterior Longitudinal Ligament With an Occupying Ratio of 60% or More [J].

Fujimori, Takahito ;

Iwasaki, Motoki ;

Okuda, Shinya ;

Takenaka, Shota ;

Kashii, Masafumi ;

Kaito, Takashi ;

Yoshikawa, Hideki .

SPINE, 2014, 39 (01) :58-67

[4]

Association of Myelopathy Scores With Cervical Sagittal Balance and Normalized Spinal Cord Volume: Analysis of 56 Preoperative Cases From the AOSpine North America Myelopathy Study.[J].Justin S. Smith;Virginie Lafage;Devon J. Ryan;Christopher I. Shaffrey;Frank J. Schwab;Alpesh A. Patel;Darrel S. Brodke;Paul M. Arnold;K. Daniel Riew;Vincent C. Traynelis;Kris Radcliff;Alexander R. Vaccaro;Michael G. Fehlings;Christopher P. Ames.Spine.2013, 22S

[5]

The Relationship Between the Anatomy of the Nuchal Ligament and Postoperative Axial Pain After Cervical Laminoplasty Cadaver and Clinical Study [J].

Ono, Atsushi ;

Tonosaki, Yoshikazu ;

Numasawa, Takuya ;

Wada, Kanichiro ;

Yamasaki, Yoshihito ;

Tanaka, Toshihiro ;

Kumagai, Gentaro ;

Aburakawa, Shuichi ;

Takeuchi, Kazunari ;

Yokoyama, Toru ;

Ueyama, Kazumasa ;

Ishibashi, Yasuyuki ;

Toh, Satoshi .

SPINE, 2012, 37 (26) :E1607-E1613

[6]

The Impact of Standing Regional Cervical Sagittal Alignment on Outcomes in Posterior Cervical Fusion Surgery [J].

Tang, Jessica A. ;

Scheer, Justin K. ;

Smith, Justin S. ;

Deviren, Vedat ;

Bess, Shay ;

Hart, Robert A. ;

Lafage, Virginie ;

Shaffrey, Christopher I. ;

Schwab, Frank ;

Ames, Christopher P. .

NEUROSURGERY, 2012, 71 (03) :662-669

[7]

The use of the T1 sagittal angle in predicting overall sagittal balance of the spine [J].

Knott, Patrick T. ;

Mardjetko, Steven M. ;

Techy, Fernando .

SPINE JOURNAL, 2010, 10 (11) :994-998

[8]

Short-term complications and long-term results of expansive open-door laminoplasty for cervical stenotic myelopathy.[J].Kazuhiko Satomi;Jun Ogawa;Yoshiaki Ishii;Kiyoshi Hirabayashi.The Spine Journal.2001, 1

[9]

BIOMECHANICAL EVALUATION OF THE EXTENSOR MUSCULATURE OF THE CERVICAL-SPINE [J].

NOLAN, JP ;

SHERK, HH .

SPINE, 1988, 13 (01) :9-11

[10]

EXPANSIVE OPEN-DOOR LAMINOPLASTY FOR CERVICAL SPINAL STENOTIC MYELOPATHY [J].

HIRABAYASHI, K ;

WATANABE, K ;

WAKANO, K ;

SUZUKI, N ;

SATOMI, K ;

ISHII, Y .

SPINE, 1983, 8 (07) :693-699

← 1 →