颈前路减压融合手术对颈椎矢状位形态的影响

Effect of anterior cervical decompression and fusion on the sagittal cervical balance

摘要:

[目的]探讨颈前路减压手术对颈椎矢状位形态的影响。[方法]回顾性分析 2019 年 5 月—2020 年 3 月在本院行颈前路减压融合术(anterior cervical decompression and fusion, ACDF)治疗退行性颈椎病且有完整随访资料 116 例患者的临床资料。比较术前及末次随访时，VAS、JOA 和 NDI 评分，以影像矢状位平衡参数的变化。[结果]所有患者手术顺利完成，术中无严重并发症。随访 12~15 个月，平均(13.52±1.43)个月。与术前相比，末次随访时 VAS 和 NDI 评分显著降低(P＜0.05)，而 JOA 评分显著增加(P＜0.05)。影像方面，与术前相比，末次随访时 C_2-7 SVA 减小，但差异无统计学意义(P＞0.05)；C_2-7Cobb 角和椎间隙高度均显著增加(P＜0.05)。[结论]颈前路减压融合手术可以直接解除脊髓、神经的压迫，并改善颈椎矢状位平衡。

Abstract:

[Objective] To explore the effect of anterior cervical decompression and fusion (ACDF) on the sagittal cervical balance. [Methods] A retrospective study was conducted on a total of 116 patients who underwent ACDF for degenerative cervical spondylosis in our hospital from May 2019 to March 2020 with complete follow-up data. The VAS, JOA, and NDI scores, as well as sagittal cervical balance parameters measured on radiographs were compared before surgery and at the last follow-up to determine the changes. [Results] All pa- tients were successfully operated on without serious complications. The patients were followed up for 12 to 15 months, with a mean of (13.52±1.43) months. The VAS and NDI scores significantly declined (P＜0.05) , while the JOA score significantly increased at the latest fol- low up compared with those preoperatively (P＜0.05) . In terms of imaging assessment, the C_2-7 SVA at the last follow-up decreased com- pared with that before surgery, but the difference was not statistically significant (P＞0.05) , whereas the C_2-7 Cobb angle and intervertebral space height significantly increased (P＜0.05) . [Conclusion] Anterior cervical decompression and fusion not only relieve the compression of spinal cord and nerves directly, but also improve the sagittal balance of cervical spine.