术前 T1 斜率对于确定颈椎重建术后患者 C2-7 Cobb 角的重要性。
The importance of preoperative T1 slope for determining proper postoperative C2-7 Cobb's angle in patients undergoing cervical reconstruction.
机构信息
Department of Orthopedics, 900th Hospital of the Joint Logistics Team, Dongfang Hospital Affiliated to Xiamen University, No. 156 Xi'er huang road, Fuzhou, 350025, China.
Department of Nephrology, 900th Hospital of the Joint Logistics Team, Dongfang Hospital Affiliated to Xiamen University, No. 156 Xi'er huang road, Fuzhou, 350025, China.
出版信息
J Orthop Surg Res. 2020 Nov 5;15(1):507. doi: 10.1186/s13018-020-02016-7.
BACKGROUND
This study aimed to explore the relationship among different cervical sagittal parameters in asymptomatic volunteers and the correlation between surgical efficacy and difference of presumed and actual postoperative C2-7 Cobbs's angle (C2-7COBB), which was calculated based on preoperative T1 slope (T1S) in patients undergoing cervical reconstruction.
METHODS
In total, 158 inpatients with cervical spondylosis and 274 asymptomatic volunteers were retrospectively reviewed. Cervical sagittal parameters, such as C2-7COBB, T1S, thoracic inlet angle (TIA), and neck tilt (NT), were compared. Then, the correlation among these parameters was analyzed in asymptomatic volunteers, and a regression equation between T1S and C2-7COBB was established and used to analyze the correlation among the Japanese Orthopaedic Association (JOA) score improvement, the sagittal parameters, and the difference between presumed and actual postoperative C2-7COBB in patients after cervical reconstruction.
RESULTS
The mean T1S, C2-7COBB, and TIA were significantly decreased in patients (P < 0.01). T1S and NT had a strong correlation with TIA (P < 0.01). T1S demonstrated a moderate correlation with C2-7COBB in asymptomatic volunteers (r = 0.569, P < 0.01). A regression equation had been established as C2-7COBB = 0.742 × T1S - 0.866. The mean C2-7COBB and JOA score improved significantly (P < 0.05) postoperatively. Moreover, the JOA improvement rate showed a significant negative correlation with the difference in the presumed and actual postoperative C2-7COBB (r = - 0.696, P < 0.01).
CONCLUSION
Our study successfully established a regression equation for calculating postsurgical C2-7COBB based on the correlation between T1S and C2-7COBB in asymptomatic volunteers. The regression equation could be used for guiding surgeons to accomplish an ideal postsurgical C2-7COBB for patients with cervical spondylosis.
背景
本研究旨在探讨无症状志愿者中不同颈椎矢状参数之间的关系，以及基于颈椎重建术前 T1 斜率（T1S）计算的假定与实际术后 C2-7 Cobb 角（C2-7COBB）之间的相关性，以及 C2-7COBB 之间的相关性。手术疗效。
方法
回顾性分析 158 例颈椎病患者和 274 例无症状志愿者的临床资料。比较颈椎矢状参数，如 C2-7COBB、T1S、胸入口角（TIA）和颈部倾斜角（NT）。然后，分析无症状志愿者中这些参数之间的相关性，并建立 T1S 与 C2-7COBB 之间的回归方程，分析颈椎重建术后患者日本骨科协会（JOA）评分改善与矢状参数之间的相关性，并分析假定与实际术后 C2-7COBB 之间的差异。
结果
患者的平均 T1S、C2-7COBB 和 TIA 显著降低（P <0.01）。T1S 和 NT 与 TIA 有很强的相关性（P <0.01）。T1S 在无症状志愿者中与 C2-7COBB 呈中度相关（r = 0.569，P <0.01）。已建立回归方程为 C2-7COBB = 0.742×T1S-0.866。术后 C2-7COBB 和 JOA 评分均显著提高（P <0.05）。此外，JOA 改善率与假定与实际术后 C2-7COBB 的差异呈显著负相关（r = -0.696，P <0.01）。
结论
本研究成功建立了基于无症状志愿者 T1S 与 C2-7COBB 之间相关性的术后 C2-7COBB 计算回归方程。回归方程可用于指导外科医生为颈椎病患者实现理想的术后 C2-7COBB。
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