单节段Mobi-C人工间盘置换与ROI-C颈椎前路融合后颈椎矢状位参数的变化  

Changes in sagittal parameters of cervical spine a?ter single-level Mobi-C artificial disc replacement and ROI-C anterior cervical fusion

作　　者：冉宇 白春晓[1] 刘楚吟 赵学千 龙水文 覃昌龙 李忠泽 张超 贾育松[1] 陈江[1] Ran Yu;Bai Chunxiao;Liu Chuyin;Zhao Xueqian;Long Shuiwen;Qin Changlong;Li Zhongze;Zhang Chao;Jia Yusong;Chen Jiang(Division 1,Department of Orthopedics,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院骨伤科一区,北京市100700

出　　处：《中国组织工程研究》2023年第27期4297-4303,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金重点项目(81930116);国家自然科学基金青年项目(81603638),项目负责人:陈江;中国博士后科学基金(222921),项目负责人:陈江;北京市东城区优秀人才培养资助项目,项目负责人:陈江。

摘　　要：背景:前期研究显示,双节段颈椎间盘置换对于颈椎矢状位参数有明显改善,且优于双节段ROI-C融合器,但不同手术节段的颈椎矢状位参数存在差异。目的:研究单节段Mobi-C人工颈椎间盘置换与ROI-C颈椎前路融合术后颈椎矢状位参数的差异。方法:回顾性分析2018年1月至2020年2月于北京中医药大学东直门医院就诊的60例神经根型、脊髓型或混合型颈椎病患者,按照手术方式分为Mobi-C间盘组和ROI-C融合组。所有患者均完成半年以上有效随访,平均随访时间为(12.1±5.0)个月,分别于术前、术后1周及末次随访时行目测类比评分、颈椎JOA评分以及拍摄X射线片,测量颈椎矢状位参数:C_(2-7)Cobb角、C_(0-2)Cobb角、C_(2-7)矢状面轴向距离、颈椎斜率、T_(1)倾斜角、C_(7)倾斜角、胸廓入口角、脊柱功能单位角,分析两组患者的组内和组间差异,并行Pearson相关性分析。结果与结论:①术后1周及末次随访时,两组患者目测类比评分均较术前明显降低(P<0.05)、颈椎JOA评分显著增高(P<0.05)。②与术前相比,术后1年的随访间盘组C_(2-7)Cobb、C_(2-7)矢状面轴向距离和T_(1)倾斜角差异无显著意义(P>0.05),C_(0-2)Cobb角、高T_(1)倾斜角减小(P<0.05),脊柱功能单位角增大(P<0.05);融合组C_(2-7)Cobb、C_(2-7)矢状面轴向距离和T_(1)倾斜角差异无显著意义(P>0.05),脊柱功能单位角和C_(7)倾斜角增高(P<0.05);间盘组比融合组脊柱功能单位角增高(P<0.05)。③患者术后矢状位参数,融合组C_(2-7)Cobb与C_(7)倾斜角呈显著正相关;颈椎斜率与胸廓入口角呈显著正相关;T_(1)倾斜角与C_(7)倾斜角呈显著正相关;C_(7)倾斜角与C_(0-2)Cobb角呈显著负相关。置换组C_(2-7)Cobb与C_(7)倾斜角、脊柱功能单位角和T_(1)倾斜角呈显著正相关,与C_(0-2)Cobb角呈显著负相关;颈椎斜率与胸廓入口角呈显著正相关,与C_(2-7)矢状面轴向距离、T_(1)倾斜角和脊柱功能单位角呈显�BACKGROUND:Preliminary studies have shown that double-level cervical disc replacement can significantly improve the sagittal parameters of the cervical spine,and is superior to the double-level ROI-C fusion cage,but there are differences in the sagittal parameters of the cervical spine in different surgical segments.OBJECTIVE:To study the differences between single-level Mobi-C artificial cervical disc replacement and sagittal parameters of the cervical spine after ROI-C anterior cervical fusion.METHODS:Sixty patients with radicular,spinal cord or mixed cervical spondylosis who were treated in Dongzhimen Hospital,Beijing University of Chinese Medicine from January 2018 to February 2020 were retrospectively analyzed and divided into Mobi-C cervical artificial disc replacement group(disc group)and ROI-C anterior cervical fusion group(fusion group)according to the surgical method.All patients completed effective follow-up for more than half a year,mean(12.1±5.0)months.Visual analogue scale scores,cervical spine JOA scores,and X-ray films were detected before and 1 week after surgery and during final follow-up.The following cervical sagittal parameters were measured:C_(2-7)Cobb angle,C_(0-2)Cobb angle,C_(2-7)sagittal vertical axis,neck tilt,T_(1)slope,C_(7)slope,thoracic inlet angle,and spinal function unit angle.Intra-and intergroup differences were analyzed between both groups.A Pearson correlation analysis was conducted.RESULTS AND CONCLUSION:(1)At the 1 week after surgery and the last follow-up,visual analogue scale scores were significantly lower than before surgery(P<0.05).Cervical spine JOA score was significantly higher(P<0.05).(2)Compared with the preoperative data,there were no significant differences in C_(2-7)Cobb angle,C_(2-7)sagittal vertical axis or T_(1)slope in intervertebral disc group(P>0.05);C_(0-2)Cobb angle and high T_(1)slope decreased(P<0.05),while spinal function unit angle increased(P<0.05).There were no significant differences in C_(2-7)Cobb angle,C_(2-7)sagittal vertical axis or T_(1)slop

关 键 词：单节段颈椎病 Mobi-C人工间盘 ROI-C融合器 颈椎矢状位参数 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R681.5