Dias Celso Garreta Prats, Roberto Bruno Braga, Basaglia Lucas, Lenza Mario, Nicolau Rodrigo Junqueira, Ferretti Mario
Hospital Israelita Albert Einstein, Departamento de Ortopedia e Traumatologia, São Paulo, SP, Brazil.
Rev Bras Ortop. 2017 Aug 24;52(5):575-581. doi: 10.1016/j.rboe.2017.08.007. eCollection 2017 Sep-Oct.
Degenerative disease of the cervical spine is a frequent source of intermittent neck pain, where the predominant symptom is axial neck pain. The indications for surgical treatment are reserved for the cases where the conservative treatment has not relieved the symptoms or the patient presents progressive neurological impairment. The objective of this study was to evaluate the prognostic factors involved in patients submitted to surgical treatment of the cervical spine.
The study analyzed data from patients submitted to cervical spine surgery between July 2011 and November 2015 ( = 58). The evaluated data included smoking habits, hypertension, diabetes, overweight, surgical technique, and number of levels of fusion. The primary outcome was defined as pain and the secondary outcomes were quality of life and disability.
A statistically significant difference was found between baseline and the 12-month post-operative results regarding pain in favor of non-hypertensive patients ( = 0.009) and discectomy plus instrumentation ( = 0.004). There was also significant difference between the results of neck disability in favor of non-hypertensive patients ( = 0.028) and patients with body mass index lower than 25 kg/m ( = 0.005). There was no significant interaction between any analyzed data and the quality of life score results.
Non-hypertensive patients, those with body mass index lower than 25 kg/m, and those submitted to discectomy combined with arthrodesis of the cervical spine are the most benefited by cervical degenerative disease surgery.
颈椎退行性疾病是间歇性颈部疼痛的常见原因,其主要症状是颈部轴性疼痛。手术治疗的适应症仅限于保守治疗未能缓解症状或患者出现进行性神经功能损害的情况。本研究的目的是评估接受颈椎手术治疗的患者的预后因素。
该研究分析了2011年7月至2015年11月期间接受颈椎手术的患者(n = 58)的数据。评估的数据包括吸烟习惯、高血压、糖尿病、超重、手术技术和融合节段数。主要结局定义为疼痛,次要结局为生活质量和残疾情况。
在疼痛方面,非高血压患者(p = 0.009)和椎间盘切除术加内固定术(p = 0.004)在基线和术后12个月的结果之间存在统计学显著差异。在颈部残疾结果方面,非高血压患者(p = 0.028)和体重指数低于25 kg/m的患者(p = 0.005)也存在显著差异。任何分析数据与生活质量评分结果之间均无显著交互作用。
非高血压患者、体重指数低于25 kg/m的患者以及接受颈椎间盘切除术联合融合术的患者从颈椎退行性疾病手术中获益最大。