Department of Orthopedic Surgery, NYU Langone Health, New York, NY, United States; Department of Neurosurgery, UT Southwestern Medical Center, Dallas, TX, United States.
Department of Orthopedic Surgery, NYU Langone Health, New York, NY, United States.
J Clin Neurosci. 2020 Jan;71:76-83. doi: 10.1016/j.jocn.2019.10.012. Epub 2019 Nov 8.
Surgical decompression using laminoplasty is commonly performed for multilevel stenosis with cervical spondylotic myelopathy. However, the long-term effects on the craniocervical range of motion (ROM) after surgery are not well understood. This study represents the first entry into the literature of photogrammetric analysis for clinical measurement of craniocervical ROM. All patients underwent a French-door laminoplasty from 1995 to 2016 and were evaluated radiologically and with postoperative photographs (photogrammetric analysis) to measure craniocervical ROM and axial rotation. Radiographic parameters were occiput to C2 angle, C1-2 angle, C2-7 angle/cervical lordosis (CL), T1-slope (T1S), and TS-CL were measured. Chin-brow vertical angle (CBVA) was utilized for flexion and extension, while nose-turn angle (NTA) was used to assess axial rotation. Forty-four patients (mean age: 65.7 years, 50% female) had a mean follow-up of 37.9 months. Mean values in neutral, flexion, and extension were occiput to C2 = 30°, 15°, and 43°; C1-C2 = -32°, -25°, -32°; and C2-C7 = -4°, 11°, -20°, respectively. Mean CL was within 1 SD of the established -17° (±13.86°). Mean T1S and TS-CL were 33° and 30° in the neutral position, respectively. Mean radiographic full range of motion from flexion to extension was 53°. NTA towards patients' left was 48° and the right side was 45°. Mean CBVA, was -4°, mean flexion 37°, and extension -45°; full range was 81°. Global craniocervical ROM has proven to be well preserved for many years following cervical laminoplasty. Photogrammetric analysis is a cost-effective and radiation-free method, accurate for quantitative assessment of craniocervical and cervical ROM.
经椎板切开术减压术常用于治疗多节段颈椎狭窄伴脊髓型颈椎病。然而，手术后对颅颈活动范围（ROM）的长期影响尚不清楚。本研究首次将摄影测量分析应用于临床测量颅颈 ROM。所有患者于 1995 年至 2016 年期间接受法式门椎板切开术，并通过术后影像学和照片（摄影测量分析）进行评估，以测量颅颈 ROM 和轴向旋转。测量的影像学参数包括枕骨至 C2 角、C1-2 角、C2-7 角/颈椎前凸（CL）、T1 斜率（T1S）和 TS-CL。颏眉垂直角（CBVA）用于评估屈伸，而鼻尖转向角（NTA）用于评估轴向旋转。44 例患者（平均年龄：65.7 岁，50%为女性）平均随访 37.9 个月。中立位、前屈位和后伸位的平均值分别为枕骨至 C2=30°、15°和 43°；C1-C2=-32°、-25°和-32°；C2-C7=-4°、11°和-20°。CL 的平均值在-17°（±13.86°）的 1 个标准差范围内。中立位时 T1S 和 TS-CL 的平均值分别为 33°和 30°。从前屈到后伸的全活动范围的平均值为 53°。患者左侧的 NTA 为 48°，右侧为 45°。CBVA 的平均值为-4°，前屈时平均值为 37°，后伸时平均值为-45°，总活动范围为 81°。颈椎椎板切开术后多年来，颅颈 ROM 被证明得到了很好的保留。摄影测量分析是一种经济有效的、无辐射的方法，可准确评估颅颈和颈椎 ROM。
