颈椎矢状力线参数与颈椎间盘退变患者退变节段及Pfirrmann分级的关联性  

Correlation of cervical sagittal force line parameters with degenerative segment and Pfirrmann classification in patients with cervical intervertebral disc degeneration

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》2023年第9期1319-1324,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:腰椎矢状位参数与腰椎间盘退变、腰椎矢状位平衡存在明显相关性,而有关颈椎的研究还相对缺乏。目的:探讨颈椎矢状力线参数颈椎前凸角、T_(1)倾斜角、矢状面位移与颈椎间盘退变患者退变节段、Pfirrmann分级的关联性及对疗效的评估价值。方法:选择2017年7月至2019年12月承德医学院附属医院收治的80例颈椎间盘退变患者,均行颈后路微创椎管扩大成形术,根据患者术后6个月疗效分组,其中疗效良好组62例,疗效不良组18例。比较两组患者的临床资料、颈椎矢状力线参数(颈椎前凸角、T_(1)倾斜角、矢状面位移),分析颈椎矢状力线参数与退变节段、Pfirrmann分级的相关性,采用受试者工作特征曲线评价颈椎矢状力线参数对疗效的评估价值。结果与结论:(1)两组患者的退变节段、Pfirrmann分级相比,差异有显著性意义(P <0.05);(2)术后1,6个月,疗效良好组患者颈椎矢状力线参数颈椎前凸角、T_(1)倾斜角大于疗效不良组,矢状面位移小于疗效不良组,差异有显著性意义(P <0.05);(3)不同退变节段、Pfirrmann分级患者颈椎矢状力线参数颈椎前凸角、T_(1)倾斜角、矢状面位移相比,差异有显著性意义(P <0.05);(4)颈椎间盘退变患者颈椎矢状力线参数颈椎前凸角、T_(1)倾斜角与退变节段、Pfirrmann分级呈正相关关系(P <0.05),矢状面位移与退变节段、Pfirrmann分级呈负相关关系(P <0.05);(5)将性别、年龄、病程、体质量指数、颈椎病类型、退变节段、Pfirrmann分级、术前颈椎矢状力线参数等其他因素控制后,术后1,6个月颈椎矢状力线参数颈椎前凸角、T_(1)倾斜角、矢状面位移仍与颈椎间盘退变患者疗效显著相关(P <0.05);(6)颈椎前凸角、T_(1)倾斜角、矢状面位移评估疗效的曲线下面积均较大,尤以联合评估最高,达0.815;(7)提示颈椎间盘退变患者颈椎矢状力线参数颈椎前凸角、T_(1)倾斜角、矢状面位�BACKGROUND:The sagittal paramete rs of lumbar spine are significantly correlated with lumbar interve rtebral disc degeneration and sagittal balance of lumbar spine,while the research on ce rvical spine is relatively lacking.OBJECTIVE:To explore the correlation of cervical sagittal force line parameters cervical lordosis,T_(1) slope,and sagittal ve rtical axis with degenerative segment,Pfirrmann classification in cervical interve rtebral disc degeneration patients and the value of therapeutic evaluation.METHODS:A total of 80 patients with ce rvical interve rtebral disc degeneration in Affiliated Hospital of Chengde Medical College from July 2017 to December2019 were selected as the study subjects,all of whom underwent minimally invasive spinal canal enlargement surge ry through the poste rior ce rvical approach.The patients were grouped according to the curative effect 6 months after the operation.Among them,there were 62 cases in the good curative effect group and 18 cases in the poor curative effect group.The clinical data,cervical sagittal force line parameters(cervical lo rdosis,T_(1) slope,and sagittal ve rtical axis) and cervical sagittal force line parameters of patients with diffe rent degeneration segments and Pfirrmann classification were compared between the two groups.The receiver operating chara cteristic curve was used to evaluate the value of the efficacy evaluation of the parameters of the cervical sagittal force line.RESULTS AND CONCLUSION:(1) There was a statistically significant difference in degeneration segments and Pfirrmann classification between the two groups(P <0.05).(2) At 1 and 6 months after operation,the cervical sagittal force line paramete rs cervical lordosis and T_(1)slope of the patients in the good curative effect group were significantly higher than those in the poor curative effect group,and the sagittal ve rtical axis was significantly lower than that in the poor curative effect group(P<0.05).(3) Cervical sagittal force line parameters cervical lo rdosis,T_(1) slope,and sagit

关 键 词：颈椎前凸角 T_(1)倾斜角 矢状面位移 颈椎间盘退变 退变节段 Pfirrmann分级 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R445