单开门椎板成形术颈椎影像参数的变化

Variations of cervical imaging parameters secondary to unilateral open-door laminoplasty

摘要:

[目的] 分析颈后路单开门椎板成形术后颈伸肌 (neck extensor muscle, NEM) 与颈椎矢状位参数变化，探讨术后 NEM 萎缩与颈椎矢状位参数变化的相关性。[方法]2015 年 1 月—2019 年 7 月于本院行颈后路单开门椎板成形术的患者共 128 例，于术前、术后 1 周，术后 1、2 年行影像检查，测量 C_2~7 Cobb 角、C_2~7 SVA 、T1 斜率，以及 NEM 的丰度 (SEA/VBA 和 DEA/VBA)及脂肪变性率。并进行相关分析。[结果]随时间推移，C_2~7 SVA、C_2-7 Cobb 角、T1S，以及 SEA/VBA、DEA/VBA 和脂肪含量均显曲线变化，各时间点间差异均有统计学意义(P＜0.05)。Spearman 相关分析表明，SEA/VBA 和 DEA/VBA 均与 C_2~7 Cobb 角的变化呈正相关 (P＜0.05)。NEM 脂肪含量与 C_2~7Cobb 角的变化呈负相关 (P＜0.05)。C7T1的 NEM 脂肪含量与 T1S 的变化呈正相关 (P＜0.05)。[结论] 颈后路单开门椎板成形术后颈椎出现后凸改变的趋势，NEM 萎缩与颈椎矢状位参数的变化具有相关性。

Abstract:

[Objective] To analyze the changes of neck extensor muscle (NEM) and cervical sagittal parameters secondary to posterior unilateral open- door laminoplasty, and to explore the correlation between postoperative NEM atrophy and cervical sagittal parameters. [Methods] A total of 128 patients underwent posterior cervical unilateral open-door laminoplasty in our hospital from January 2015 to July 2019. Imaging examinations were performed before surgery, 1 week after surgery, 1 year after surgery and 2 years after surgery to measure the C2~7 Cobb angle, C2~7 SVA and T1S, additionally the SEA/VBA and DEA/VBA, which presented the abundance of NEM, as well as the fat content of the NEM. Correlation analysis was conducted between the sagittal plan parameters and the NEM measurements. [Results] The C2~7 SVA, C2~7 Cobb angle, T1S, as well as SEA/VBA, DEA/VBA and NEM fat content had curve variations over time, which were statistical- ly significant among time points (P＜0.05) . As consequences of Spearman analysis, the SEA/VBA and DEA/VBA were significantly positive- ly correlated with C2~7 Cobb angle and C2-7 SVA (P＜0.05) , whereas the NEM fat content was significantly negatively correlated with the C2~7 Cobb angle (P＜0.05) , and the fat content of C7/T1 NEM was positively correlated with T1S (P＜0.05) . [Conclusion] The cervical spine pres- ents a trend of lordosis after posterior unilateral open-door laminoplasty, and NEM atrophy is correlated with the changes of cervical sagit- tal parameters.