Liu Xiao-Ming, Pan Fu-Min, Yong Zhi-Yao, Ba Zhao-Yu, Wang Shan-Jin, Liu Zheng, Zhao Wei-Dong, Wu De-Sheng
Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Medicine (Baltimore). 2017 Mar;96(12):e6365. doi: 10.1097/MD.0000000000006365.
The aim of the study was to evaluate the role of the longus colli muscles in cervical vertigo.We retrospectively analyzed 116 adult patients who underwent anterior cervical discectomy and fusion (ACDF) during 2014 in our department. Patients were assigned to the vertigo group or the nonvertigo group. Demographic data were recorded. Inner distance and cross-sectional area (CSA) of longus colli were measured using coronal magnetic resonance imaging (MRI).The vertigo group (n = 44) and the nonvertigo group (n = 72) were similar in demographic data. Mean preoperative Japanese Orthopaedic Association (JOA) score was higher in the vertigo group than in the nonvertigo group (P = 0.037), but no difference postoperatively. Mean JOA scores increased significantly postoperatively in both groups (P = 0.002 and P = 0.001). The mean vertigo score decreased significantly from pre- to postoperatively in the vertigo group (P = 0.023). The mean preoperative Cobb angle was significantly smaller in the vertigo group than in the nonvertigo group (P <0.001), but no significant difference postoperatively. After ACDF, the mean Cobb angle increased significantly in the vertigo group (P <0.001). The instability rates of C3/4 and C4/5 were significantly higher in the vertigo group (P <0.001 and P <0.001). The inner distance of longus colli was significantly shorter (P = 0.032 and P = 0.026) and CSA significantly smaller (P = 0.041 and P = 0.035), at C3/4 and C4/5 in the vertigo group than in the nonvertigo group. Mean Miyazaki scores were significantly higher in the vertigo group at C3/4 and C4/5 (P = 0.044 and P = 0.037). Moreover, a shorter inner distance and smaller CSA were related to a higher Miyazaki score.Inner distance and cross-sectional area (CSA) of longus colli are associated closely with cervical vertigo. Shorter inner distance and smaller CSA of the longus colli muscles might be risk factors for cervical vertigo. ACDF provided a good resolution of cervical vertigo.
本研究的目的是评估颈长肌在颈性眩晕中的作用。我们回顾性分析了2014年在我科接受颈椎前路椎间盘切除融合术（ACDF）的116例成年患者。将患者分为眩晕组和非眩晕组。记录人口统计学数据。使用冠状面磁共振成像（MRI）测量颈长肌的内距和横截面积（CSA）。眩晕组（n = 44）和非眩晕组（n = 72）在人口统计学数据方面相似。眩晕组术前日本骨科协会（JOA）评分均值高于非眩晕组（P = 0.037），但术后无差异。两组术后JOA评分均值均显著增加（P = 0.002和P = 0.001）。眩晕组眩晕评分均值从术前到术后显著降低（P = 0.023）。眩晕组术前平均Cobb角显著小于非眩晕组（P <0.001），但术后无显著差异。ACDF术后，眩晕组平均Cobb角显著增加（P <0.001）。眩晕组C3/4和C4/5节段的不稳定率显著更高（P <0.001和P <0.001）。眩晕组C3/4和C4/5节段颈长肌的内距显著更短（P = 0.032和P = 0.026），CSA显著更小（P = 0.041和P = 0.035）。眩晕组C3/4和C4/5节段的宫崎评分均值显著更高（P = 0.044和P = 0.037）。此外，较短的内距和较小的CSA与较高的宫崎评分相关。颈长肌的内距和横截面积（CSA）与颈性眩晕密切相关。颈长肌较短的内距和较小的CSA可能是颈性眩晕的危险因素。ACDF对颈性眩晕提供了良好的治疗效果。
