摘要
目的探讨基于影像学的颈椎后路减压内固定术疗效影响因素。方法选择2017年10月~2020年8月本院收治的70例脊髓型颈椎病患者,均采用颈椎后路减压内固定术治疗,采用JOA评分评价术前、术后6个月的神经功能变化,并根据JOA评分改善率分为优良组、可差组。比较两组相关影像学参数,包括术前Cobb角、压迫物最大径等,组间进行单因素分析后,再进行多因素二元Logistic回归分析。结果70例术后疗效优32例,良26例,可10例,差2例;优良组、可差组的术前Cobb角、压迫物最大径、脊髓漂移距离、椎管侵占率、有效椎管率差异有统计学意义(P<0.05),两组受压节段、脊髓横截面积差异无统计学意义(P>0.05);多因素Logistic回归分析显示,压迫物最大径、脊髓漂移距离、椎管侵占率是颈椎后路减压内固定术疗效的影响因素。结论压迫物、椎管侵占率较大,脊髓漂移距离较短,均是颈椎后路减压内固定术治疗脊髓型颈椎病近期疗效的影响因素。
Objective To explore the factors influencing the efficacy of image-based posterior decompression and internal fixation of cervical spine.Methods Seventy patients with spinal cervical spondylosis from October 2017 to August 2020 were selected,and all patients were treated with posterior decompression and internal fixation of the cervical spine.The neurological changes were evaluated by using the JOA score preoperatively and 6 months postoperatively,and the patients were divided into the excellent group and the poor group according to the improvement rate of JOA score.The relevant imaging parameters,including preoperative Cobb angle and maximum diameter of the compression,were compared between the two groups,and univariate analysis was performed between the two groups followed by multivariate logistic regression analysis.Results Of 70 patients received posterior decompression and internal fixation of the cervical spine,the clinical effect was excellent in 32 patients,good in 26 patients,fair in 10 patients,and poor in 2 patients.The preoperative Cobb angle,maximum diameter of the compressive material,drift distance of the spinal cord,spinal canal encroachment rate,and effective spinal canal rate were significantly different between the two groups(P<0.05),while there were no significant differences in the compressive segment and spinal cord cross-sectional area between the two groups(P>0.05).The multivariate logistic regression analysis showed that the maximum diameter of the compressive material,drift distance of the spinal cord,and spinal canal encroachment were significant influencing factors on the efficacy of posterior cervical decompression and internal fixation.Conclusion Compression,larger spinal canal invasion rate,shorter spinal cord drift distance,are the influence factors of the short-term curative effect of posterior cervical decompression and internal fixation in the treatment of cervical spondylotic myelopathy.
作者
林金堆
LIN Jin-dui(Department of Spine Spinal Surgery,Zhongshan Hospital,Affiliated to Xiamen University,Xiamen,Fujian 361000,China)
出处
《颈腰痛杂志》
2021年第4期481-483,共3页
The Journal of Cervicodynia and Lumbodynia
关键词
影像学参数
脊髓型颈椎病
颈椎后路减压内固定术
疗效影响因素
radiographic parameters
cervical spondylotic myelopathy
posterior cervical decompression and internal fixation
efficacy influencing factors
