摘要
目的 进行脊髓型颈椎病颈椎体次全切除融合术(anterior cervical corpectomy and fusion,ACCF)术后出现钛笼下沉的危险因素Logistic回归分析,为其预后的改善提供理论依据。方法纳入2014年6月~2017年6于我院行ACCF术治疗的102例脊髓型颈椎病患者,随访6个月,将钛笼下沉者设为下沉组,其余设为未下沉组。调查两组患者性别、影像检查等病历资料,采用单因素、多因素分析确定颈椎ACCF术后出现钛笼下沉的独立危险因素。结果术后20例发生钛笼下沉,下沉率19.61%;两组钛笼直径、椎体撑开程度、钛笼倾斜角、钛笼前缘与临近椎体前缘距离、钉板夹角差异具有统计学意义( P <0.05);多因素分析钛笼直径(OR=2.321)、椎体撑开程度(OR=1.897)、钛笼倾斜角(OR=2.043)、钛笼前缘与临近椎体前缘距离(OR=2.248)是颈椎ACCF术后出现钛笼下沉的独立危险因素。结论脊髓型颈椎病患者ACCF术后钛笼下沉发生率较高,钛笼直径、椎体撑开程度、钛笼倾斜角、钛笼前缘与临近椎体前缘距离等均会增加钛笼下沉风险。
Objective To perform the Logistic regression analysis of the risk factors of titanium cage subsidence after anterior cervical corpectomy and fusion (ACCF) in cervical spine, and provide a theoretical basis for improving the prognosis of ACCF. Methods A total of 102 patients with cervical spondylotic myelopathy treated with ACCF in our hospital from June 2014 to June 2017 were selected in this study. During a follow-up of 6 months, the subsidence situation of titanium cage was investigated. Patients with titanium cage subsidence were set as a sinking group, and the rest patients were set as a non-sinking group. The data of medical records such as gender and imaging examination were observed in the two groups. Univariate and multivariate analysis were used to determine the independent risk factors of titanium cage subsidence after ACCF in the cervical spine. Results Twenty cases with titanium cage subsidence happened after ACCF, and the rate of subsidence was 19.61%. The differences of diameters of titanium cages, the degree of vertebral body distraction, the tilt angle of titanium cages and the distance of anterior edge of titanium cage and adjacent anterior edge of vertebral body and nail-plate angle were statistically significant between the two groups ( P <0.05). Multi-factor analysis showed that titanium cage diameter (OR=2.321), vertebral body distensibility (OR=1.897), titanium cage tilt angle (OR=2.043) and the distance of anterior edge of titanium cage and adjacent anterior edge of vertebral body (OR=2.248) were the independent risk factors of titanium cage subsidence after ACCF in the cervical spine. Conclusion The incidence of titanium cage subsidence after ACCF is higher in patients with cervical spondylotic myelopathy. Diameter of titanium cage, extent of vertebral body expansion, tilt angle of titanium cage and distance between titanium cage leading edge and adjacent vertebral body can increase the subsidence risk of titanium cage.
作者
韩俊
黄勇
HAN Jun;HUANG Yong(Department of Spinal Surgery, Hanyang Hospital of Wuhan, Wuhan,Hubei, 430050, China;Wuhan General Hospital of Guangzhou Military Region, Wuhan, Hubei, 430070, China)
出处
《颈腰痛杂志》
2019年第4期442-444,共3页
The Journal of Cervicodynia and Lumbodynia
