脊髓型颈椎病后路单开门椎管扩大成形术脊髓功能恢复水平的影响因素分析  

Influencing factors of recovery of spinal cord function after posterior unilateral open-door laminoplasty for cervical spondylotic myelopathy

作　　者：刘德丰[1] 崔玉杰[1] 李广章[2] 张玉舰[2] LIU De-feng;CUI Yu-jie;LI Guang-zhang;ZHANG Yu-jian(Medical Imaging Center,First Hospital of Qinhuangdao,Qinhuangdao,Hebei 066000,China;不详)

机构地区：[1]秦皇岛市第一医院医学影像中心,河北066000 [2]秦皇岛市第一医院骨科,河北066000

出　　处：《中国骨与关节损伤杂志》2022年第7期673-677,共5页Chinese Journal of Bone and Joint Injury

基　　金：河北省科技计划项目(199477142G);秦皇岛市科学技术研究与发展计划(201805A174)。

摘　　要：目的分析脊髓型颈椎病采用后路单开门椎管扩大成形术治疗后脊髓功能恢复水平的影响因素。方法回顾性分析自2016-01—2019-01采用颈椎后路单开门椎管扩大减压内固定治疗的60例脊髓型颈椎病,44例术后1年JOA评分改善率≥50%(观察组),16例术后1年JOA评分<50%(对照组)。采用单因素分析对两组的性别、年龄、病程、术前颈椎Cobb角、C_(5)后缘到k线的距离、颈椎管内平均压迫率、颈椎管内最大压迫率、是否髓内MRI T2WI高信号进行组间比较,差异有统计学意义的指标纳入多因素Logistic回归分析。结果单因素分析结果显示观察组与对照组在年龄、性别、病程、术前颈椎Cobb角、颈椎管内平均压迫率比较差异无统计学意义(P>0.05),两组在C_(5)后缘到k线的距离、颈椎管内最大压迫率、T2WI髓内是否出现高信号比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示C_(5)后缘到k线的距离较短、颈椎管内最大压迫率较高、髓内MRI T2WI高信号是脊髓型颈椎病后路单开门椎管扩大成形术后功能恢复不良的独立危险因素(P<0.05)。结论C_(5)后缘到k线的距离较短、颈椎管内最大压迫率较高、髓内MRI T2WI出现高信号是脊髓型颈椎病后路单开门椎管扩大成形术后脊髓功能恢复不良的独立危险因素。Objective To analyse influencing factors of the recovery of spinal cord function after posterior unilateral open-doorlaminoplasty and internal fixation for cervical spondylotic myelopathy.Methods From January 2016 to January 2019,60 cases of cervical spondylotic myelopathy treated with posterior unilateral open-door laminoplasty and internal fixation were analyzed retrospectively.The improvement rate of JOA score in 44 cases was≥50%(observation group),and the JOA score in 16 cases was<50%(control group).Univariate analysis was used to compare the gender,age,course of disease,preoperative cervical Cobb angle,the distance from the posterior edge of C_(5) to the k line,the average compression rate in the cervical spinal canal,the maximum compression rate in the cervical spinal canal,and whether there was the T2WI high signal of intramedullary MRI in the two groups,and the indexes with statistically significant differences were included in multivariate logistic regression analysis.Results Univariate analysis showed that there was no significant difference between the observation group and the controlgroup in age,gender,course of disease,preoperative cervical Cobb angle and average compression rate in cervical canal(P>0.05).There were significant differences between the two groups in the distance from the posterior edge of C_(5) to the k line,themaximum compression rate in the cervical spinal canal,and whether there was high signal in T2WI(P<0.05).Multivariate logistic regression analysis showed that the short distance from the posterior edge of C_(5) to the k line,the high maximum compressionrate in the cervical spinal canal and the high signal of T2WI on intramedullary MRI were independent risk factors of poor functional recovery after single door laminoplasty for cervical spondylotic myelopathy(P<0.05).Conclusion The short distance from the posterior edge of C_(5) to the k line,the high maximum compression rate in the cervical spinal canal and the high signal on T2WI of intramedullary MRI are independent risk fac

关 键 词：脊髓型颈椎病 后路单开门椎管扩大成形术 JOA评分 危险因素 

分 类 号：R687.3[医药卫生—骨科学]