摘要
【目的】探讨术前MRI中胸1倾斜角(T1slope,T1S)对单节段颈椎前路椎间盘切除融合术(anterior cervical discectomy fusion,ACDF)后颈椎曲度的变化是否有预测作用。【方法】回顾分析2015年1月至2018年1月本院收治的48例因颈椎病接受单节段ACDF治疗患者的临床资料,根据术前MRI中T1S中位数(21°)分为A组(T1S≤21°)和B组(T1S>21°),比较两组患者术前及末次随访时的C2-7Cobb角、C2-C7矢状位垂直距离(C2-C7sagittal vertical axis,C2-C7SVA)、手术节段Cobb角(segment cobb angle,SCobb)、△SCobb角和△C2-7Cobb角(末次随访与术前参数之差)。【结果】48例患者均获有效随访,出血量(67.50±51.09)ml,手术时间(143.43±40.54)min,随访时间6~44个月,平均11.5个月,末次随访时Cobb角和SCobb角都较术前有明显改善,末次随访时的C2-C7SVA较术前有明显减少;术前MRI中的T1S和术前及末次随访的SCobb角和C2-7Cobb角都具有显著相关性,而与C2-C7SVA无显著相关性;经协方差分析比较发现,两组患者间末次随访C2-7Cobb角和C2-C7SVA差异无统计学意义,末次随访SCobb角的差异有统计学意义,A组与B组中△C2-7Cobb角差异无统计学意义,但△SCobb角差异具有统计学意义。【结论】单节段ACDF可改善整体颈椎曲度和手术节段颈椎曲度,术前MRI中T1S>21°有利于矫正手术节段颈椎曲度。
【Objective】To investigate whether T1 slope(T1 S)in preoperative MRI can predict the change of cervical lordosis after anterior cervical discectomy fusion(ACDF).【Methods】The clinical data of 48 patients undergoing single-segment ACDF for cervical spondylosis from January 2015 to January 2018 were retrospectively analyzed.According to the T1 S(21°)medium of preoperative MRI,the patients were divided into group A(T1 S≤21°)and group B(T1 S>21°).The C2-7 Cobb angle,C2-C7 sagittal vertical axis(C2-C7 SVA),segment Cobb angle(SCobb),△SCobb angle and△C2-7 Cobb angle(the difference between the last follow-up and preoperative parameters)were compared between the two groups.【Results】All the 48 patients were followed up effectively.The amount of bleeding was(67.50±51.09)ml,the operation time was(143.43±40.54)min,and the follow-up time was 6 to 44 months,with an average of11.5 months.Both the follow-up Cobb angle and Scobb angle were significantly increased and the C2-C7 SVA was significantly decreased,compared with those before operation.Both T1 S in preoperative MRI and SCobb and C2-7 Cobb angles before and at the last follow-up were significantly correlated,but not significantly correlated with C2-C7 SVA.The analysis of covariance revealed that the difference between C2-7 Cobb angle and C2-C7 SVA was not statistically significant at the last follow-up.However,the difference in SCobb at the last follow-up between the two groups was statistically significant.There was no significant difference in the△C2-7 Cobb angle between group A and group B,but the difference in△SCobb angle was statistically significant.【Conclusion】Single-segment ACDF can improve the overall cervical lordosis and surgical segment cervical lordosis.When T1 S>21°in preoperative MRI,it is helpful to correct the cervical lordosis of the surgical segment.
作者
程招军
崔子健
任志帅
张黎龙
CHENG Zhao-jun;CUI Zi-jian;REN Zhi-shuai;ZHANG Li-long(Tianjin University of Tradition Chinese Medicine,Tianjin 301600,China)
出处
《武警后勤学院学报（医学版）》
CAS
2019年第12期13-17,共5页
Journal of Logistics University of PAP（Medical Sciences）
