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[单节段人工颈椎间盘置换术后钩椎关节退变严重程度与异位骨化的相关性]

[The correlation between the severity of uncovertebral joints degeneration and heterotopic ossification after single-level artificial cervical disc replacement].

作者信息

Cao S, Pan S F, Sun Y, Zhao Y B, Zhou F F, Chen X, Diao Y Z, Xia T, Zhang F S, Zhang L

机构信息

Department of Orthopedics, Peking University Third Hospital, Beijing Key Laboratory of Spinal Disease Research, Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing 100191, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2020 Dec 8;100(45):3578-3583. doi: 10.3760/cma.j.cn112137-20200811-02347.

Abstract

To investigate the correlation between the severity of uncovertebral joints degeneration and heterotopic ossification (HO) after single-level artificial cervical disc replacement (ACDR). From January 2005 to January 2016, 70 patients who had undergone single-level ACDR in Peking University Third Hospital and had at least 5 years follow-up were included in this study. There were 35 males and 35 females with an average age of (42±8) years (range, 25-62 years). Cervical spine A-P X-rays were taken to assess the degeneration of uncovertebral joints and lateral X-rays were taken to assess the degeneration of intervertebral space. Cervical spine lateral and the flexion-extension X-rays at 5 years follow up were taken to assess HO. Degeneration of uncovertebral joints were evaluated by the classification system set-up in Peking University Third Hospital. Kellgren&Lawrence grading system was used to evaluate the degeneration of intervertebral space. HO was evaluated by the McAfee grading standards. The data were collected before surgery and at 5-years follow-up, then the correlation between degeneration of uncovertebral joints, degeneration of intervertebral space and HO was analyzed with Spearman non-parametric test. The average follow-up time of 70 patients was (62.7±4.8) years (range, 52-74 months). There was a significant positive correlation between preoperative uncovertebral joints degeneration and HO after ACDR (0.585, 0.01). There was a significant positive correlation between preoperative intervertebral space degeneration and HO (0.557, 0.01). There was a significant positive correlation between preoperative intervertebral space degeneration and preoperative uncovertebral joints degeneration (0.727, 0.01). There is a significant positive correlation between preoperative uncovertebral joints degeneration and HO after ACDR.

摘要

探讨单节段人工颈椎间盘置换术(ACDR)后钩椎关节退变严重程度与异位骨化(HO)之间的相关性。2005年1月至2016年1月,纳入北京大学第三医院行单节段ACDR且至少随访5年的70例患者。其中男性35例,女性35例,平均年龄(42±8)岁(范围25 - 62岁)。拍摄颈椎正位X线片评估钩椎关节退变情况,拍摄侧位X线片评估椎间隙退变情况。随访5年时拍摄颈椎侧位及屈伸位X线片评估HO情况。采用北京大学第三医院制定的分类系统评估钩椎关节退变。采用Kellgren&Lawrence分级系统评估椎间隙退变。采用McAfee分级标准评估HO。收集术前及随访5年时的数据,然后采用Spearman非参数检验分析钩椎关节退变、椎间隙退变与HO之间的相关性。70例患者的平均随访时间为(62.7±4.8)个月(范围52 - 74个月)。ACDR术后,术前钩椎关节退变与HO之间存在显著正相关(0.585,P = 0.01)。术前椎间隙退变与HO之间存在显著正相关(0.557,P = 0.01)。术前椎间隙退变与术前钩椎关节退变之间存在显著正相关(0.727,P = 0.01)。术前钩椎关节退变与ACDR术后HO之间存在显著正相关。

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