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[1]徐政,刘艺.颈前路椎体次全切减压植骨融合术后枕骨-颈椎矢状面形态学研究[J].医学研究与战创伤救治(原医学研究生学报),2018,20(03):258-262.[doi:10.3969/j.issn.1672-271X.2018.03.009]
　XU Zheng,LIU Yi.The study of occipital - cervical sagittal morphologica after anterior cervical vertebral body subtotal decompression[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2018,20(03):258-262.[doi:10.3969/j.issn.1672-271X.2018.03.009]
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颈前路椎体次全切减压植骨融合术后枕骨-颈椎矢状面形态学研究()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第20卷
期数:
2018年03期
页码:
258-262
栏目:
出版日期:
2018-05-09

文章信息/Info

Title:
The study of occipital - cervical sagittal morphologica after anterior cervical vertebral body subtotal decompression
作者:
徐政; 刘艺
作者单位：222000连云港，徐州医科大学附属连云港医院骨科（徐政、刘艺）
Author(s):
XU Zheng;  LIU Yi
(Department of Orthopedice，Xuzhou Medical University Affiliated Hospital of Lianyungang,Lianyungang 222000，Jiangsu，China)
关键词:
颈椎病; 椎体次全切; 矢状面形态; 颈椎曲度
Keywords:
cervical spondylosis;  corpectomy decompression;  sagittal morphology;  cervical curvature
分类号:
R681.5
DOI:
10.3969/j.issn.1672-271X.2018.03.009
文献标志码:
A
摘要:
目的 研究颈前路椎体次全切减压融合术（ACCF）术后枕骨-颈椎矢状面形态。方法 回顾性分析2010年10月至2016年4月行颈前路椎体次全切减压植骨融合术43例患者临床资料，其中男23例，女20例，年龄45～71（54.6±8.2）岁，术后随访时间10～15（11.7±3.6）个月。所有患者均在术前、术后1个月、末次随访摄颈椎正侧位片，并测量枕骨入射角（occipital incidence，OI）、枕骨斜率（occipital slope，OS）、枕骨倾斜角（occipital title，OT），以及上颈椎前凸角（C0-2）、下颈椎前凸角（C2-7）、颈椎前凸角（C0-7）、颈椎矢状面垂直距离（C2-7 sagittal vertical axis，C2-7 SVA）、T1倾斜角（thoracic1-slope，T1S）等枕骨-颈椎矢状面参数。采用独立样本t检验比较术前与术后1个月，术后1个月与末次随访之间的差异。结果 患者术前、术后1个月及末次随访组中，OI、OS和OT均无显著变化（P>0.05）。术后1个月与术前比较，C0-2[（25.3°±9.8°） vs （19.5°±10.1°）]，C2-7[（15.2°±8.3°） vs （11.3°±7.6°）]，C0-7[（35.7°±8.1°） vs （31.8°±9.6°）]，C2-7 SVA[（22.8±11.5）mm vs （17.3±10.9）mm]，T1S[（26.7°±6.3°） vs （23.2°±8.3°）]均明显增加（P<0.05）。末次随访与术后1个月比较，C0-2[（20.8°±8.1°） vs （25.3°±9.8°）]，C2-7[（11.4°±5.8°） vs （15.2°±8.3°）]，C0-7[（32.5°±6.6°） vs （35.7°±8.1°）]，C2-7 SVA[（18.0±10.7）mm vs（22.8±11.5）mm]，T1S[（24.1°±5.6°） vs （26.7°±6.3°）]均显著减小（P<0.05）。结论 ACCF术后短期表现颈椎过度前凸，颈椎前倾增加，出现短暂的失平衡，引起轴性症状，需严格颈托固定；但长期随访发现，颈椎曲度得到明显改善，轴性症状也得到缓解。
Abstract:
Objective To evaluate the occipital-cervical sagittal alignment after anterior cervical corpectomy and fusion (ACCF).Methods This is a retrospective analysis of 43 patients, who were admitted from October 2010 to April 2016 for anterior cervical corpectomy and fusion. There are 23 males and 20 females, mean age was 45-71 (54.6±8.2) years, mean follow-up was 10-15 (11.7±3.6) months. Standing radiographs of cervical spine were obtained preoperatively, postoperative-1w and at final follow-up. The occipital-cervical sagittal alignment were assessed with the following parameters: occipital incidence (OI), occipital slope (OS), occipital title (OT) and C0-2 Cobb angle, C2-7 Cobb angle, C0-7 Cobb angle, C2-7 sagittal vertical axis, T1-slope. Independent samples test was used to analyze the differences of radiographic parameters.Results There were no significance in OI, OS, OT in preoperative, postoperative-1w and last follow-up groups (P＞0.05). C0-2 [(25.3°±9.8°) vs (19.5°±10.1°)], C2-7 [(15.2°±8.3°) vs (11.3°±7.6°)], C0-7 [(35.7°±8.1°) vs (31.8°±9.6°)], C2-7 SVA [(22.8±11.5) mm vs (17.3±10.9) mm] and T1S [(26.7°±6.3°) vs (23.2°±8.3°)] were significantly higher in postoperative-1w group than those preoperatively (P＞0.05). However, C0-2 [(20.8°±8.1°) vs (25.3°±9.8°)], C2-7 [(11.4°±5.8°) vs (15.2°±8.3°)], C0-7 [(32.5°±6.6°) vs (35.7°±8.1°)], C2-7 SVA [(18.0±10.7) mm vs (22.8±11.5) mm], T1S [(24.1°±5.6°) vs (26.7°±6.3°)] were lower significantly at final follow-up than those in postoperative-1w group (P＜0.05).Conclusion The sagittal balance of cervical spine changes in short time after ACCF with forward tilting and cervical lordosis. While in the long run, cervical curvature has obvious improvement, which proved that ACCF would have few impacts on The sagittal balance of cervical spine.

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2018-05-20