Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, People's Republic of China.
Department of Geriatric Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan Province, People's Republic of China.
Eur Spine J. 2019 Aug;28(8):1864-1871. doi: 10.1007/s00586-019-05972-9. Epub 2019 Apr 22.
To investigate the effects of cervical decompression operation on cardiac autonomic regulation and its relationship to recovery of somatic neurological function in cervical spondylotic myelopathy (CSM) patients.
One hundred and thirty-two consecutive patients were enrolled in this study, in which 73 patients received decompression operation and the remaining 59 were treated non-operatively. The follow-up period was 6 months. Baseline and follow-up evaluation included Japanese Orthopaedic Association (JOA) score, office-based blood pressure (BP) measurement, heart rate (HR), and 24-h heart rate variability (HRV) assessment. Relationship between achieved JOA score (final JOA score-baseline score) and changes of BP, HR, and HRV parameters in both operative and non-operative groups was analyzed.
In operative group, patients' JOA score and markers of parasympathetic activity in HRV assessment were significantly higher than baseline level 6 months later. Blood pressure, especially systolic blood pressure (SBP), was significantly downregulated in both hypertension and non-hypertension patients. Mean heart rate was also significantly decreased. Furthermore, achieved JOA score was significantly negatively correlated with changes of SBP, minimal HR, mean HR, maximum HR, but significantly positively correlated with changes of HRV parameters reflecting parasympathetic activity. However, changes of JOA score, BP, HR, and HRV parameters in non-operative group were not significant.
Cervical decompression operation could improve both somatic neurological function and cardiac autonomic regulation in CSM patients, and achieved JOA score was significantly positively correlated with improvement in HRV and cardiac parasympathetic activity. These slides can be retrieved under Electronic Supplementary Material.
探讨颈椎减压手术对脊髓型颈椎病（CSM）患者心脏自主调节的影响及其与躯体神经功能恢复的关系。
本研究纳入了 132 例连续患者，其中 73 例接受减压手术，其余 59 例接受非手术治疗。随访时间为 6 个月。基线和随访评估包括日本骨科协会（JOA）评分、办公血压（BP）测量、心率（HR）和 24 小时心率变异性（HRV）评估。分析手术和非手术组中达到的 JOA 评分（最终 JOA 评分-基线评分）与 BP、HR 和 HRV 参数变化之间的关系。
在手术组中，患者的 JOA 评分和 HRV 评估中副交感神经活动标志物在 6 个月后明显高于基线水平。血压，特别是收缩压（SBP），在高血压和非高血压患者中均显著下调。平均心率也显著降低。此外，达到的 JOA 评分与 SBP、最小 HR、平均 HR、最大 HR 的变化呈显著负相关，但与反映副交感神经活动的 HRV 参数的变化呈显著正相关。然而，非手术组的 JOA 评分、BP、HR 和 HRV 参数的变化不显著。
颈椎减压手术可改善 CSM 患者的躯体神经功能和心脏自主调节，达到的 JOA 评分与 HRV 和心脏副交感神经活动的改善显著正相关。这些幻灯片可以在电子补充材料中检索到。
