摘要
目的探讨严重颈椎后纵韧带骨化症(OPLL)患者颈椎后路双开门椎管扩大椎板成形术后C_5神经根麻痹的发生率与椎管占位率的关系。方法回顾性分析本院2014年1月—2017年1月采用颈椎后路双开门椎管扩大椎板成形术治疗的44例严重OPLL患者(椎管占位率>50%)的临床资料。以术后是否发生C_5神经根麻痹将患者分为麻痹组(11例)和非麻痹组(33例)。所有患者进行影像学检查,测量并记录患者椎管占位率,累及椎体数量,OPLL分型,术前、术后Cobb角和神经功能日本骨科学会(JOA)评分,并计算Cobb角和JOA评分改善率。采用t检验分析以上因素组间差异是否有统计学意义,对差异有统计学意义的因素采用Spearman相关分析和Logistic回归分析评价其与C_5神经根麻痹的相关性。结果 t检验结果显示2组间椎管占位率、术前JOA评分、术后JOA评分及JOA评分改善率差异有统计学意义(P<0.05),纳入相关分析。Spearman相关分析结果显示椎管占位率与术后C_5神经根麻痹呈正相关;术前、术后JOA评分及JOA评分改善率与术后C_5神经根麻痹呈负相关。Logistic回归分析只有椎管占位率进入方程,椎管占位率与术后C_5神经根麻痹具有相关性。结论严重颈椎OPLL患者术后C_5神经根麻痹发生率较高。椎管占位率与术后C_5神经根麻痹呈正相关,椎管占位率越高,C_5神经根麻痹发生率越高。
Objective To investigate the relationship between the incidence of C_5 palsy and the vertebral canal occupying ratio after posterior cervical double open-door laminoplasty in severe cervical ossification of the posterior longitudinal ligament(OPLL). Methods From January 2014 to June 2017,a total of 44 patients with severe OPLL(vertebral canal occupying rate > 50%) were divided into 2 groups according to whether has postoperative C_5 palsy :11 in palsy group and 33 in non-palsy group. All the patients underwent imaging examination. The vertebral canal occupying ratio,the number of vertebrae involved,OPLL classification,preoperative and postoperative Cobb's angles and Japanese Orthopaedic Association(JOA) scores for neurological funcion were measured and recorded. And the improvement rate of Cobb's angle and JOA score were calculated. The t test was used to analyze whether the differences in above factors between the 2 groups were statistically significant. Spearman correlation analysis and Logistic regression analysis were used to evaluate the correlation between statistically different factors and postoperative C_5 palsy. Results The results of t test showed that there were significant differences between the 2 groups in vertebral canal occupying ratio,preoperative JOA score,postoperative JOA score and improvement rate of JOA score(P < 0.05),which were included in the correlation analysis. Spearman correlation analysis showed that vertebral canal occupying ratio was positively correlated with postoperative C_5 palsy. Preoperative and postoperative JOA scores and improvement rate of JOA score were negatively correlated with postoperative C_5 palsy. Logistic regression analysis showed that only vertebral canal occupying ratio entered the equation,and the vertebral canal occupying ratio was associated with postoperative C_5 palsy. Conclusion The incidence of postoperative C_5 palsy is higher in patients with severe cervical OPLL. The vertebral canal occupying ratio is positively correlated with postoperative C_5 palsy. The higher the vertebral canal occupying ratio,the higher the incidence of postoperative C_5 palsy.
出处
《脊柱外科杂志》
2018年第1期31-34,共4页
Journal of Spinal Surgery
关键词
颈椎
骨化
后纵韧带
椎管狭窄
神经根病
减压术
外科
手术后并发症
Cervical vertebrae
Ossification of posterior longitudinal ligament
Spinal stenosis
Radiculopathy
Decompression
surgical
Postoperative complications
