Epstein Nancy E
Albert Einstein College of Medicine, Bronx, NY, USA.
Spine (Phila Pa 1976). 2004 Jun 15;29(12):1340-5. doi: 10.1097/01.brs.0000127195.35180.08.
Three outcome measures, Nurick grades, Odom's criteria, and the Short Form (SF-36) were analyzed following circumferential cervical surgery in 47 patients.
To analyze three outcome measures following circumferential surgery.
Few studies use multiple outcome criteria to assess circumferential surgery.
Patients averaged 54 years of age and exhibited severe myelopathy (Nurick grade 3.6). Corpectomies of 2.6 vertebrae (on average) were followed by posterior fusions (C2-T1) with halo stabilization. Initial fixed-plates (n = 28) and subsequent dynamic ABC plates (Aesculap, Tuttlingen, Germany) (n = 19) were applied, Fusion was confirmed on dynamic radiographs and two-dimensional CT studies 3, 6, and up to 12 months after surgery. Nurick grades and Odom's criteria were evaluated 1 and 2 years after surgery. Results of SF-36 questionnaires, obtained before surgery, 6 weeks, 3 months, 6 months, 1 year, 2 years after surgery, were calculated.
Neurodiagnostic studies confirmed fusion on average 5.0 months after surgery. One and 2 years after surgery, mean Nurick grades were 0.8 (+2.8 points) and 0.4 (+3.2 points), respectively. One year (2 years) postoperative Odom's criteria revealed excellent 26 (30), good 14 (11), fair 6 (5), and poor 1 (1) patient outcomes. Comparing preoperative with 1-year postoperative SF-36 questionnaires revealed moderate improvement on 5 health scales: Social Function (+19.9), Bodily Pain (+19.6), Role-Physical (+18.8), Physical Function (+12.5), and Role-Emotional (+11.1). Minimal additional improvement occurred over the second year: Role-Physical (+21.6), Social Function (+16.4), Bodily Pain (+13.4), Physical Function (+12.8), and Role Emotional (+9.5).
Based on three outcome measures, the greatest improvement occurs 1 year following circumferential surgery.
对47例接受颈椎环形手术的患者，分析了三种疗效评估指标，即Nurick分级、奥多姆标准和简短健康调查问卷（SF - 36）。
分析颈椎环形手术后的三种疗效评估指标。
很少有研究使用多种疗效标准来评估颈椎环形手术。
患者平均年龄54岁，表现为严重脊髓病（Nurick分级为3.6级）。平均切除2.6个椎体后，进行后路融合术（C2 - T1）并采用头环固定。最初应用固定钢板（n = 28），随后应用动态ABC钢板（德国图特林根的蛇牌公司生产）（n = 19）。在术后3个月、6个月及长达12个月时，通过动态X线片和二维CT检查确认融合情况。在术后1年和2年评估Nurick分级和奥多姆标准。计算术前、术后6周、3个月、6个月、1年、2年时SF - 36问卷的结果。
神经诊断研究证实平均术后5.0个月实现融合。术后1年和2年时，平均Nurick分级分别为0.8（提高2.8分）和0.4（提高3.2分）。术后1年（2年）的奥多姆标准显示，患者疗效为优26例（30例）、良14例（11例）、中6例（5例）、差1例（1例）。术前与术后1年的SF - 36问卷比较显示，5个健康量表有中度改善：社会功能（提高19.9）、身体疼痛（提高19.6）、角色 - 身体（提高18.8）、身体功能（提高12.5）和角色 - 情感（提高11.1）。在第二年的改善幅度最小：角色 - 身体（提高21.6）、社会功能（提高16.4）、身体疼痛（提高13.4）、身体功能（提高12.8）和角色情感（提高9.5）。
基于三种疗效评估指标，颈椎环形手术后最大程度的改善出现在术后1年。
