Department of Spine Surgery, Zhongda Hospital, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009, China.
School of Medicine, Southeast University, Nanjing, 210009, China.
J Orthop Surg Res. 2020 Aug 14;15(1):325. doi: 10.1186/s13018-020-01836-x.
ACDF treatment of CSM is currently recognized as a surgical method with reliable efficacy. However, the cervical radiographic findings in a certain group of patients showed that the symptoms were not completely relieved. This study will investigate the relationship between cervical parameters and prognoses after ACDF surgery.
This study collected cases of CSM treated with ACDF in Zhongda Hospital from May 2014 to June 2018. The investigators recorded gender, age, cervical sagittal parameters, fusion segment, BMI, symptom duration, and NDI score. To compare the changes of parameters after surgery and explore the correlation between each factor and NDI score.
Generally, cervical lordosis increased and TS-CL decreased after surgery and during follow-up. Postoperative T1S, SVA and SCA decreased significantly compared to preoperative. T1S was positively correlated with CL (r = 0.245), SVA (r = 0.184), and negatively correlated with SCA (r = - 0.314) and NT (r = - 0.222). The last follow-up NDI score was positively correlated with T1S (r = 0.689), SVA (r = 0.155), TS-CL (r = 0.496), and age (r = 0.194), while negatively correlated with SCA (r = - 0.142). A linear regression model was established with the following formula: NDI = 0.809 × (T1S) - 0.152 × (CL) + 1.962 × (Sex) + 0.110 × (Age). T1S (B = 0.205, P < 0.001), CL (B = - 0.094, P = 0.041), and NT (B = 0.142, P = 0.023) were independent risk factors that affected whether the last follow-up NDI score was greater than preoperative.
In ACDF treatment of CSM, there exists a close correlation between cervical sagittal parameters and NDI scores. T1S, CL, sex, and age were linearly dependent on NDI scores. The increase of T1S, NT, and the decrease of CL were risk factors that affected follow-up NDI score greater than preoperative. Reducing T1S is beneficial to clinical recovery.
ACDF 治疗 CSM 目前被认为是一种疗效可靠的手术方法。然而，某些患者的颈椎影像学表现显示症状并未完全缓解。本研究将探讨 ACDF 手术后颈椎参数与预后的关系。
本研究收集了 2014 年 5 月至 2018 年 6 月在中大医院接受 ACDF 治疗的 CSM 病例。研究者记录了患者的性别、年龄、颈椎矢状位参数、融合节段、BMI、症状持续时间和 NDI 评分。比较手术后参数的变化，探讨各因素与 NDI 评分的相关性。
一般来说，颈椎曲度术后和随访期间增加，TS-CL 减少。与术前相比，术后 T1S、SVA 和 SCA 显著降低。T1S 与 CL（r = 0.245）、SVA（r = 0.184）呈正相关，与 SCA（r = - 0.314）和 NT（r = - 0.222）呈负相关。末次随访 NDI 评分与 T1S（r = 0.689）、SVA（r = 0.155）、TS-CL（r = 0.496）和年龄（r = 0.194）呈正相关，与 SCA（r = - 0.142）呈负相关。建立了以下公式的线性回归模型：NDI = 0.809 ×（T1S）-0.152 ×（CL）+1.962 ×（Sex）+0.110 ×（Age）。T1S（B = 0.205，P < 0.001）、CL（B = - 0.094，P = 0.041）和 NT（B = 0.142，P = 0.023）是影响末次随访 NDI 评分大于术前的独立危险因素。
在 ACDF 治疗 CSM 中，颈椎矢状位参数与 NDI 评分密切相关。T1S、CL、性别和年龄与 NDI 评分呈线性相关。T1S、NT 增加和 CL 减少是影响随访 NDI 评分大于术前的危险因素。降低 T1S 有利于临床恢复。
