基于CT检查的颈椎人工间盘置换术后椎旁骨化长期进展评价  

Evaluation of long-term progress of paravertebral ossification after cervical disc replacement based on CT examination

作　　者：曾成[1] 田伟[1] 刘波[1] 韩骁[1] 范明星[1] ZENG Cheng;TIAN Wei;LIU Bo;HAN Xiao;FAN Mingxing(Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院,北京100035

出　　处：《山东医药》2020年第20期1-5,共5页Shandong Medical Journal

基　　金：北京市医院管理局使命人才计划项目(SML20150401)。

摘　　要：目的借助CT检查,观察并评价颈椎人工间盘置换(CADR)术后邻近节段及正常节段椎旁骨化(PO)的长期进展程度。方法CADR术后患者45例,将各颈椎节段分为手术节段组、邻近节段组和非邻近节段组(对照组)。分别于术前和末次随访(随访57~108个月)时进行颈椎CT图像采集。以各节段椎体中心为圆心,划分为四个功能区域,即左侧钩椎关节区域(L)、右侧钩椎关节区域(R)、前方区域(A)、后方区域(P),对患者C 2~3至C 7~T 1节段各区域进行PO分级。结果手术节段组、邻近节段组、对照组的L、R、A、P区域术后高级别PO(2级和3级)比例均高于术前(P均<0.05)。手术节段组的L、R区域PO进展比例均高于对照组(P均<0.01)。手术节段组的A、P区域PO进展比例与对照组差异无统计学意义,邻近节段组各区域PO进展比例与对照组差异无统计学意义。结论借助CT检查长期随访发现,CADR术后手术节段PO发生率较术前明显增高;CADR对于手术节段PO进展的影响主要集中在钩椎关节区域,而对前后区域的PO进展影响较小;CADR对邻近节段PO进展的影响不显著。Objective To observe the long-term progress of paravertebral ossification(PO)of adjacent segments and normal segments following cervical artificial disc replacement(CADR)based on CT examination.Methods Forty-five patients who underwent CADR were included.The segments were divided into the following groups:operative level,adjacent level,or non-adjacent level groups(control group).Preoperative and final follow-up CT images(range 57-108 months)were collected.We took the center of each segment of the vertebral body as the center of a circle and divided each segment into four areas:left Luschka joint area(L),right Luschka joint area(R),anterior area(A),posterior area(P).PO from the C 2/3 to C 7/T 1 segments in each patient was graded based on CT images.Results The proportion of high-level PO(grades 2 and 3)in every areas in the operative level group,adjacent level group,and control group was higher than that before surgery(P<0.05).Progression of PO in L and R areas in the operative level group was significantly more severe than that in the control group(P<0.05).There was no significant difference in PO progression in the A and P areas between the operative level group and the control group,and there was no significant difference in PO progression between the adjacent level group and the control group(both P>0.05).Conclusions The incidence of PO after CADR is significantly higher in comparison with that in the preoperative status.Progression of PO with CADR at the operative level is concentrated in areas of the Luschka joints rather than A and P areas.CADR has little influence on the progression of PO development in the adjacent segments.

关 键 词：颈椎人工间盘置换术 椎旁骨化 CT检查 异位骨化 邻近节段 

分 类 号：R681.5[医药卫生—骨科学]