颈椎矢状面序列参数对脊髓型颈椎病患者疼痛、颈椎功能及临床疗效的评估价值  

Evaluation value of cervical sagittal plane sequence parameters on pain,cervical function and clinical efficacy in patients with cervical spondylotic myelopathy

作　　者：曹胜 孔令伟[1] 徐昆[1] 孙志杰[1] Cao Sheng;Kong Lingwei;Xu Kun;Sun Zhijie(Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei Province,China)

机构地区：[1]承德医学院附属医院,河北省承德市067000

出　　处：《中国组织工程研究》2022年第3期419-424,共6页Chinese Journal of Tissue Engineering Research

基　　金：承德市科技支撑计划项目(201904A050),项目负责人:曹胜。

摘　　要：背景:脊髓型颈椎病是由颈椎椎骨间连接结构退变而诱发,而颈椎矢状面序列参数可直接反映其退变情况,或可为临床评估病情及治疗效果提供参考。目的:探究脊髓型颈椎病患者颈椎矢状面序列参数变化与疼痛程度、颈椎功能的相关性,并分析上述参数对临床疗效的评估价值。方法:选取承德医学院附属医院2019年1月至2020年1月收治的80例脊髓型颈椎病患者作为试验组,按照1∶1原则选取同期80例无症状成人志愿者作为对照组,比较两组颈椎矢状面序列参数,包括C2-7Cobb’s角、T1倾斜角、颈椎矢状面轴向距离、C2-7Cobb’s角与T1倾斜角比值(C2-7/T1),分析颈椎矢状面序列参数与脊髓型颈椎病发生的关系。试验组随访6个月,根据日本骨科协会评分分为优良组(评分改善率≥50%)与非优良组(评分改善率<50%),比较不同疗效患者的临床资料、手术前后疼痛目测类比评分、日本骨科协会评分、颈椎矢状面序列参数变化情况,分析颈椎矢状面序列参数与目测类比评分、日本骨科协会评分、疗效的相关性,采用受试者工作特征曲线评价各参数对疗效的评估价值。结果与结论:(1)试验组C2-7 Cobb’s角、C2-7/T1小于对照组,T1倾斜角、颈椎矢状面轴向距离大于对照组(P<0.05);C2-7 Cobb’s角、T1倾斜角、颈椎矢状面轴向距离、C2-7/T1与脊髓型颈椎病发生显著相关(P<0.05);(2)疗效优良组与非优良组患者的压迫节段、手术方式、术前、术后1,6个月目测类比评分、日本骨科协会评分对比,差异有显著性意义(P<0.05);(3)疗效优良组患者术前、术后1,6个月C2-7 Cobb’s角、C2-7/T1大于非优良组,T1倾斜角、颈椎矢状面轴向距离小于非优良组(P<0.05);(4)目测类比评分与术前、术后1,6个月T1倾斜角、颈椎矢状面轴向距离呈正相关,与C2-7 Cobb’s角、C2-7/T1呈负相关;日本骨科协会评分与术前、术后1,6个月C2-7 Cobb’s角、C2-7/T1�BACKGROUND:Cervical spondylotic myelopathy is induced by the degeneration of the intervertebral junction structure of the cervical spine.The sequence parameters of the sagittal plane of the cervical spine can directly reflect the degeneration of cervical spondylotic myelopathy,which may provide reference for clinical evaluation of the condition and treatment effect.OBJECTIVE:To explore the correlation of the changes of cervical sagittal plane sequence parameters and pain degree and cervical function in patients with cervical spondylotic myelopathy,and to analyze its value in clinical efficacy evaluation.METHODS:From January 2019 to January 2020,80 cervical spondylotic myelopathy patients in Affiliated Hospital of Chengde Medical College were selected as the trial group,and 80 asymptomatic adult volunteers during the same period were selected as the control group according to the 1∶1 principle.The parameters of the cervical spine sagittal plane sequence[C2-7 Cobb’s angle,T1 tilt angle,cervical sagittal axial distance,ratio of C2-7 Cobb’s angle to T1 tilt angle(C2-7/T1)]were compared between the two groups.The relationship between the parameters of the cervical spine sagittal plane sequence and the occurrence of cervical spondylotic myelopathy was analyzed.After follow up for 6 months,according to the Japanese Orthopaedic Association score,they were divided into excellent group(Japanese Orthopaedic Association score improvement rate≥50%)and non-excellent group(Japanese Orthopaedic Association score improvement rate<50%).The clinical data of patients with different curative effects,the pain(visual analogue scale)score before and after the operation,the Japanese Orthopaedic Association score,and the changes in the parameters of the cervical sagittal plane sequence were compared.The correlation between the cervical spine sagittal sequence parameters and visual analogue scale,Japanese Orthopaedic Association scores and curative effect was analyzed,and the receiver operating characteristic curve was used to eval

关 键 词：脊髓型颈椎病 疼痛 颈椎功能 颈椎矢状面轴向距离 T1倾斜角 受试者工作特征曲线 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]