前路颈椎融合临床评分与影像测量的相关性  

Correlation between clinical scores and imaging measurements in anterior cervical discectomy and fusion

作　　者：于潇 汪海滨 刘小雷 陈德健 YU Xiao;WANG Hai-bin;LIU Xiao-lei;CHEN De-jian(Department of Orthopedics,The Fourth Affiliated Hospital,Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学第四附属医院骨科,江苏南京210000

出　　处：《中国矫形外科杂志》2023年第3期210-214,共5页Orthopedic Journal of China

基　　金：南京市中医药青年人才培养计划项目(编号:ZYQ20075)。

摘　　要：[目的]探讨前路颈椎融合术对颈椎影像学参数的影响及颈椎影像学参数与临床评分的相关性。[方法]回顾性分析2019年4月—2021年4月在本院行颈前路减压融合术治疗退行性颈椎病128例患者的临床资料。分析临床评分与影像测量的相关性。[结果]所有患者手术顺利完成,术中无严重并发症,随访12~20个月,平均(14.5±1.9)个月。随时间推移,128例患者的JOA评分显著增加(P<0.05),而NDI和VAS评分均显著下降(P<0.05)。随时间推移,寰椎倾斜角无显著变化(P>0.05);与术前相比,术后1年时枢椎倾斜角显著减小(P<0.05);术后1年时上颈椎曲度较术前显著减少(P<0.05)。随时间推移,下颈椎曲度呈先上升后下降趋势,差异有统计学意义(P<0.05)。相关分析方面,术前JOA评分与寰椎倾斜角呈显著负相关(P<0.05);NDI评分与枢椎倾斜角呈显著正相关(P<0.05)。术后1年JOA评分与寰椎倾斜角呈显著负相关(P<0.05);NDI评分与枢椎倾斜角呈显著正相关(P<0.05)。其他临床和影像指标间不存在相关性(P>0.05)。[结论]前路颈椎减压融合手术能够改善颈椎功能及生活质量,影像参数在一定程度上反映临床效果。[Objective]To explore the effect of anterior cervical discectomy and fusion(ACDF)on radiographic parameters of the cervi⁃cal spine and the correlation between imaging parameters and clinical scores.[Methods]A retrospective study was conducted on 128 pa⁃tients who received ACDF for cervical degenerative diseases(CDD)in our hospital from April 2019 to April 2021.The correlation between clinical score and imaging measurement was analyzed.[Results]All patients had ACDF performed successfully without serious complica⁃tions,and followed up for 12~20 months with an average of(14.5±1.9)months.The JOA score increased significantly(P<0.05),while the NDI and VAS scores decreased significantly over time(P<0.05).In terms of radiographic measurements,the C1 inclination angle remained unchanged over time(P>0.05),whereas the C2 inclination angle significantly reduced at 1 year after surgery(P<0.05),the upper cervical curvature significantly reduced at 1 year after operation compared with that before surgery(P<0.05),and the lower cervical curvature tended to first rise and then decreased with statistically significant differences over time(P<0.05).As results of correlation analysis,preoperative JOA score was negatively correlated with the C1 inclination angle(P<0.05),additionally,the NDI score was positively correlated with C2 in⁃clination angle(P<0.05).At 1 year postoperatively,the JOA score proved still negatively correlated with the C1 inclination angle(P<0.05),whereas NDI score was positively correlated with C2 inclination angle(P<0.05).However,no correlation was found between other clinical and radiological parameters(P>0.05).[Conclusion]The ACDF does improve cervical function and quality of life of the patients,and imag⁃ing parameters might reflect clinical outcomes to a certain extent.

关 键 词：颈椎退行性病变 颈前路减压融合手术 影像测量参数 临床评分 

分 类 号：R687[医药卫生—骨科学]