Fujibayashi Shunsuke, Neo Masashi, Yoshida Makoto, Miyata Masahiko, Takemoto Mitsuru, Nakamura Takashi
Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
J Spinal Disord Tech. 2010 May;23(3):197-202. doi: 10.1097/BSD.0b013e3181a1a73e.
A prospective study to investigate serial changes in neck muscle strength before and after cervical laminoplasty.
To examine the correlation between neck muscle strength and axial symptoms, and to clarify the risk factors for axial symptoms.
Axial symptoms are common complications after posterior cervical spinal surgery. Although several technical considerations have reduced axial symptoms, the causes of axial symptoms are still largely unknown. Previous studies have indicated that neck muscle strength is reduced in patients with neck pain.
Nineteen consecutive patients underwent cervical expansive laminoplasty for cervical spondylotic myelopathy. Age, sex, operative time, blood loss, clinical results, cervical curvature, range of motion, visual analog scale (VAS) for axial symptoms, and manual muscle strengths were examined before and after surgery. At 3 and 12 months, these factors were compared statistically between the no pain (NP) group (VAS <3) and the pain (P) group (VAS >or=3). The correlation between VAS and neck muscle strength, and the reduction in neck muscle strength in extension were analyzed statistically.
Six patients (31.5%) complained of axial symptoms at 3 months, and the symptoms continued in 3 patients (15.8%) at 12 months. At 3 months, cervical lordosis was 15.7 degrees in the NP group and 5.0 degrees in the P group, and neck strength in extension was 104.9% and 61.8%, respectively. At 12 months, neck strength in extension was 124.3% and 62.2%, respectively. These differences were statistically significant. The correlation between neck pain VAS and neck muscle strength, and the reduction in neck muscle strength in extension were statistically significant.
Neck muscle strength recovered to the preoperative value by 3 months and increased to 120% by 12 months in the NP group, whereas in the P group, neck muscle strength remained reduced by 60% and did not recover. Neck muscle strength and axial symptoms were strongly correlated.
一项前瞻性研究，旨在调查颈椎椎板成形术前和术后颈部肌肉力量的系列变化。
研究颈部肌肉力量与轴性症状之间的相关性，并阐明轴性症状的危险因素。
轴性症状是颈椎后路手术后常见的并发症。尽管一些技术上的考虑减少了轴性症状，但轴性症状的病因仍大多未知。先前的研究表明，颈部疼痛患者的颈部肌肉力量会降低。
19例连续的患者因脊髓型颈椎病接受颈椎扩大椎板成形术。在手术前后检查患者的年龄、性别、手术时间、失血量、临床结果、颈椎曲度、活动范围、轴性症状的视觉模拟评分（VAS）以及徒手肌力。在3个月和12个月时，对无痛（NP）组（VAS<3）和疼痛（P）组（VAS≥3）的这些因素进行统计学比较。对VAS与颈部肌肉力量之间的相关性以及伸展时颈部肌肉力量的降低情况进行统计学分析。
6例患者（31.5%）在3个月时出现轴性症状，3例患者（15.8%）在12个月时症状仍持续。在3个月时，NP组的颈椎前凸为15.7度，P组为5.0度，伸展时的颈部力量分别为104.9%和61.8%。在12个月时，伸展时的颈部力量分别为124.3%和62.2%。这些差异具有统计学意义。颈部疼痛VAS与颈部肌肉力量之间的相关性以及伸展时颈部肌肉力量的降低情况具有统计学意义。
NP组颈部肌肉力量在3个月时恢复到术前值，在12个月时增加到120%，而P组颈部肌肉力量仍降低60%且未恢复。颈部肌肉力量与轴性症状密切相关。
