Kawaguchi Yoshiharu, Nagami Shigeharu, Nakano Masato, Yasuda Taketoshi, Seki Sjoji, Hori Takeshi, Kimura Tomoatsu
Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Toyama, Japan.
Eur J Orthop Surg Traumatol. 2013 Jul;23 Suppl 1:S53-8. doi: 10.1007/s00590-013-1219-9. Epub 2013 Apr 7.
An axial symptom is one of the postoperative problems after cervical laminoplasty. The range of motion (ROM) of the cervical spine decreases after laminoplasty. It is speculated that the reduction in neck ROM is one of the causes of axial symptoms. However, most reports have focused on ROM of the cervical spine in flexion and extension, and few papers describe the rotational motion after surgery. It is impossible to assess the rotational motion in plain X-rays. This study was undertaken for the following two purposes: (1) to compare segmental rotational angles of the cervical spine between control subjects and patients with cervical laminoplasty ; (2) to analyze the relationship between postoperative axial symptoms and the range of cervical rotational angle after laminoplasty.
Eleven young volunteers (control 1 group) and 10 elderly subjects (control 2 group) who did not have any neck problems and 23 patients who had en bloc cervical laminoplasty due to cervical spondylotic myelopathy were included. Dynamic CT scan was conducted in neutral, right, and left maximum rotational positions from C1 to T1. We measured the rotational angle in each vertebral segment. The axial symptoms, such as limited neck motion and neck stiffness, were assessed by a questionnaire. The rotational angle of the cervical spine was compared between the patients with axial symptoms and the subjects without.
The rotational angle in control 1 group was greater than that in control 2 group. The rotational angle was markedly decreased in the patients with cervical laminoplasty compared to that in control 2 group. The reduction was observed at the upper vertebral segment. Twelve patients were judged to have axial symptom after cervical laminoplasty (symptom + group), and 11 patients did not have symptoms (symptom - group). The rotational angle in the symptom + group was significantly smaller than that in symptom - group. The reduction in the rotational angle was found below C2 level, whereas the C1-2 angle was not significantly different in the two symptom groups.
Reduction of the rotational angle in the cervical spine was clearly observed in patients with cervical laminoplasty, compared to that in the controls. The marked reduction might be related to the axial symptoms after laminoplasty.
轴性症状是颈椎椎板成形术后的术后问题之一。椎板成形术后颈椎的活动范围（ROM）会减小。据推测，颈部ROM的降低是轴性症状的原因之一。然而，大多数报告都集中在颈椎屈伸的ROM上，很少有论文描述术后的旋转运动。在普通X线片中无法评估旋转运动。本研究出于以下两个目的进行：（1）比较对照组受试者与颈椎椎板成形术患者颈椎的节段旋转角度；（2）分析术后轴性症状与椎板成形术后颈椎旋转角度范围之间的关系。
纳入11名无任何颈部问题的年轻志愿者（对照组1）、10名无颈部问题的老年受试者（对照组2）以及23例因脊髓型颈椎病接受整块颈椎椎板成形术的患者。在从C1至T1的中立位、右侧和左侧最大旋转位进行动态CT扫描。我们测量了每个椎体节段的旋转角度。通过问卷评估轴性症状，如颈部活动受限和颈部僵硬。比较有轴性症状的患者和无轴性症状的受试者之间颈椎的旋转角度。
对照组1的旋转角度大于对照组2。与对照组2相比，颈椎椎板成形术患者的旋转角度明显减小。在上位椎体节段观察到了这种减小。23例颈椎椎板成形术后有12例被判定有轴性症状（症状+组），11例没有症状（症状-组）。症状+组的旋转角度明显小于症状-组。旋转角度的减小在C2水平以下被发现，而两个症状组的C1-2角度没有显著差异。
与对照组相比，颈椎椎板成形术患者的颈椎旋转角度明显减小。这种显著减小可能与椎板成形术后的轴性症状有关。
Zotero 插件