摘要
背景:近年来研究者对颈椎融合后相邻节段退变给予很多的关注,但对单一术式经前路颈椎椎体次全切除钛网椎间置入融合术后相邻节段退变的研究并不多。目的:探讨经前路椎体次全切除钛网椎间置入融合后相邻节段退变的相关因素。方法:纳入2009年2月至2012年2月行经前路椎体次全切除钛网椎间置入融合的患者共126例,其中资料完整的122例纳入研究。均由同一治疗组完成,且手术均涉及单个椎体及2个间盘。终末随访期为3年。根据术前及术后相邻节段退变程度,分为非相邻节段退变进展组和相邻节段退变进展组,比较2组患者的性别、年龄、术前相邻节段退变、颈椎活动度、术椎上下位椎体活动度、手术节段、钛网下沉、钛板两端至终板的距离及颈椎曲度指数。应用二元Logistic回归方程分析相邻节段退变的相关因素。结果与结论:12组比较,术前退变、颈椎活动度、上位椎体活动度、下位椎体活动度、颈椎曲度指数差异有显著性意义(P<0.05),纳入多因素分析;2得到回归方程模型为:相邻节段退变进展=0.317×颈椎活动度(术后)+3.374×术前退变+1.862×下位椎体活动度-0.795×颈椎曲度指数-16.481;得出术后颈椎活动度、术前退变、术椎下位椎体活动度、颈椎曲度指数是相邻节段退变进展的相关因素(P<0.05);3结果提示,术后颈椎活动度、术前退变、术椎下位椎体活动度、颈椎曲度指数是相邻节段退变的相关因素,应在行经前路椎体次全切除钛网椎间置入融合术前、术中、术后积极实施有效措施预防相邻节段退变。
BACKGROUND： In recent years, the researchers have studied the adjacent segment degeneration after cervical fusion. Several studies concerned the adjacent segment degeneration after anterior cervical corpectomy and fusion. OBJECTIVE： To evaluate the correlative factors of adjacent segment degeneration after anterior cervical corpectomy and fusion. METHODS： 122 patients were included in the study from 126 patients who underwent anterior cervical corpectomy and fusion that operated by the same treatment team and involved a single vertebral body and the two plates between February 2009 and February 2012. The final follow-up period was 3 years. According to the degeneration progress of adjacent segment degeneration, these patients were divided into non-progression group and progression group. The gender, age, preoperative adjacent segment degeneration, cervical range of motion, upper and lower vertebral range of motion, surgical segment, titanium mesh subsidence, plate-to-disc distance, and cervical curvature index were compared between two groups. Logistic regression analysis was applied to analyze the correlative factors of adjacent segment degeneration. RESULTS AND CONCLUSION： （1） There were significant differences in preoperative adjacent segment degeneration, postoperative cervical range of motion, postoperative upper and lower vertebral range of motion, and postoperative cervical curvature index （P 〈 0.05）, which were included in logistic regression analysis. （2） Logistic regression analysis regression model： adjacent segment degeneration=0.317x postoperative cervical range of motion＋3.374xpreoperative adjacent segment degeneration＋1.862 x postoperative lower vertebral range of motion-0.795xpostoperative cervical curvature index-16.481. Logistic regression analysis demonstrated that preoperative range of motion, postoperative cervical range of motion, postoperative lower vertebral range of motion and postoperative cervical curvature index were correlative factors of range of motion af
出处
《中国组织工程研究》
CAS
北大核心
2016年第35期5216-5223,共8页
Chinese Journal of Tissue Engineering Research
