【摘要】：目的 :分析采用ROI-C行頸前路單節(jié)段椎間盤切除減壓融合(anterior cervical discectomy and fusion,ACDF)術(shù)后融合器沉降的相關(guān)因素。方法:回顧總結(jié)采用ROI-C行單節(jié)段ACDF治療頸椎間盤退變性疾病的83例患者資料。記錄患者年齡、性別、手術(shù)節(jié)段、吸煙史及骨密度檢查結(jié)果。在術(shù)前頸椎側(cè)位X線片上測(cè)量頸椎整體曲度(cervical alignment,CA)、融合節(jié)段角度(segmental angle,SA)、椎間隙前高度(anterior disc height,ADH)和椎間隙后高度(posterior disc height,PDH)。將隨訪的中立位頸椎側(cè)位X線片與術(shù)后即刻比較,ADH或PDH丟失2mm判定為融合器沉降,分入沉降(subsidence)組(S組,22例),并記錄沉降的部位;≤2mm分入未沉降(nonsubsidence)組(N組,61例)。應(yīng)用獨(dú)立樣本t檢驗(yàn)、χ~2檢驗(yàn)對(duì)以上參數(shù)行組間比較,采用多變量Logistic回歸分析單節(jié)段ACDF術(shù)后ROI-C沉降的危險(xiǎn)因素。將危險(xiǎn)因素進(jìn)一步分組使用χ~2檢驗(yàn)計(jì)算似然比(likelihood ratio,LR)進(jìn)行評(píng)價(jià)。結(jié)果 :單節(jié)段ACDF術(shù)后ROI-C沉降發(fā)生率為26.5%(22/83),其中陷入椎體前方終板者占63.6%(14/22)。S組、N組年齡分別為59.86±12.11歲、52.77±10.34歲,差異有統(tǒng)計(jì)學(xué)意義(P=0.010);性別、吸煙史、手術(shù)節(jié)段和骨密度均無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。S組術(shù)前的CA、SA、ADH分別為-0.800°±5.637°、0.432°±2.162°和3.768±1.210mm,N組分別為4.893°±5.718°、1.198°±1.826°和5.066±1.257mm,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.001,P=0.031和P0.001),兩組的PDH差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.092)。多變量Logistic回歸分析顯示術(shù)前CA和年齡是ROI-C沉降的危險(xiǎn)因素(P=0.014和P=0.038)。根據(jù)術(shù)前CA情況將患者分為術(shù)前CA后凸(CA0°)和前凸(CA≥0°)組,根據(jù)術(shù)前年齡將患者分為60歲和≥60歲組,χ~2檢驗(yàn)顯示術(shù)前CA后凸和60歲以上病例ROI-C沉降概率分別比前凸和60歲以下病例高12.5倍和4.5倍(LR=12.529,P0.001;LR=4.454,P=0.030)。結(jié)論 :術(shù)前CA后凸和年齡60歲以上是單節(jié)段ACDF術(shù)后ROI-C沉降的危險(xiǎn)因素。選擇ROI-C行單節(jié)段ACDF治療頸椎間盤退變性疾病時(shí)應(yīng)考慮這兩項(xiàng)因素的影響。
[Abstract]:Objective: to analyze the factors related to the reduction of fusion cage after anterior cervical discectomy and decompression and fusion of (anterior cervical discectomy and fusion (ACDF) with ROI-C. Methods: the data of 83 patients with cervical disc degeneration treated by single segment ACDF with ROI-C were retrospectively reviewed. Age, sex, surgical segment, smoking history and bone mineral density were recorded. The cervical curvature (CA), the angle of fusion segment (segmental angle SA), the height of anterior intervertebral space (anterior disc) and the height of posterior intervertebral space (posterior disc height) were measured on cervical lateral radiographs before operation. The lateral radiographs in the neutral position of cervical vertebrae were compared with those in the immediate after operation. The patients were divided into two groups: group S (n = 22) and group S (n = 22), and 鈮，

本文編號(hào)：2159086