神经根型颈椎病行前路减压融合手术预后的行为风险因素分析  

Behavioral risk factors for prognosis of cervical spondylotic radiculopathy patients undergoing anterior decompression and fusion surgery

作　　者：许标[1] 刘国庆[1] 孙科研 白石[1] 杨晋 XU Biao;LIU Guo-qing;SUN Ke-yan;BAI Shi;YANG Jin(Department of Orthopedics,People's Hospital of Jiyuan,Jiyuan,Henan 454650,China)

机构地区：[1]济源市人民医院骨一科,河南济源454650

出　　处：《颈腰痛杂志》2021年第2期181-184,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨神经根型颈椎病(cervical spondylotic radiculopathy,CSR)行颈前路减压椎间融合术(anterior cervical discectomy and fusion,ACDF)的临床疗效,并分析影响手术预后的行为风险因素。方法对本院自2017年2月~2020年1月开展ACDF手术的152例CSR患者临床资料进行回顾性分析。依据术后3个月的改良MacNab疗效评价标准,将优和良的患者列入疗效满意组,可和差的患者列入不满意组。统计两组患者的性别、年龄、体质量指数、糖尿病史、高血压史、文化水平等基础资料,以及吸烟、酗酒、睡眠时间、枕高、伏案时间、运动锻炼等行为风险因素资料,进行组间单因素分析;将单因素分析中具备P<0.05的项目进一步予以赋值,进行多因素Logistic回归分析。结果152例中,优59例(38.8%),良74例(48.7%),可16例(10.5%),差3例(2.0%)。将优+良的133例(87.5%)作为满意组,另19例(12.5%)作为不满意组。疗效不满意组的年龄>50岁、有吸烟史、运动锻炼≤3次/周的构成比均显著高于疗效满意组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示:年龄>50岁(OR=7.518)、有吸烟史(OR=8.171)和运动锻炼≤3次/周(OR=4.683),均是导致CSR患者接受ACDF手术预后不良的独立风险因素。结论年龄、吸烟和运动锻炼情况对CSR患者行ACDF手术预后可产生明显影响,其中年龄>50岁、有吸烟史和运动锻炼≤3次/周的患者预后较差。Objective To investigate the clinical effect of anterior cervical discectomy and fusion(ACDF)in the treatment of cervical spondylotic radiculopathy(CSR),and analyze the behavioral risk factors for prognosis.Methods The clinical data of 152 CSR patients who had undergone ACDF surgery in our hospital from February 2017 to January 2020 were retrospectively analyzed.According to the improved MacNab efficacy evaluation criteria at 3 months after surgery,patients with excellent and good effect were included in the satisfactory group,and patients with fair and poor effect were included in the unsatisfactory group.Basic data such as gender,age,body mass index,history of diabetes,hypertension and education level of patients in two groups were statistically analyzed,as well as behavioral risk factors such as smoking,alcohol abuse,sleep time,pillow height,desk time,exercise and so on.In the univariate analysis,the items with P<0.05 were further assigned to perform multivariate Logistic regression analysis.Results Of the 152 cases,59 cases(38.8%)were excellent,74 cases(48.7%)were good,16 cases(10.5%)were fair,and 3 cases(2.0%)were poor.The 133 patients(87.5%)with excellent and good effect were considered as satisfied group,and the other 19 cases(12.5%)were considered as dissatisfied group.The composition ratio of age>50 years old,smoking history and exercise≤3 times/week in the group with unsatisfactory efficacy was significantly higher than that in the group with satisfactory efficacy(P<0.05).Multivariate Logistic regression analysis showed that age>50 years old(OR=7.518),smoking history(OR=8.171)and exercise≤3 times per week(O R=4.683)were independent risk factors for poor prognosis of CSR patients undergoing ACDF surgery.Conclusion Age,smoking and exercise significantly affect the prognosis of CSR patients undergoing ACDF surgery.Among them,patients aged>50 years old with a history of smoking and exercise≤3 times/week had a poor prognosis.

关 键 词：神经根型颈椎病 颈前路减压椎间融合术 行为风险因素 

分 类 号：R687.3[医药卫生—骨科学]