Department of Spinal Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, People's Republic of China.
BMC Surg. 2021 Jun 12;21(1):291. doi: 10.1186/s12893-021-01293-1.
To explore the relationship between spino cranial angle (SCA) and loss of cervical lordosis (LOCL), and to determine whether SCA has the ability to predict LOCL for patients with cervical myelopathy.
A total of 68 consecutive patients with cervical myelopathy who received laminoplasty (LAMP) were selected to the current study. C2-C7 lordosis was defined as a representation of the cervical alignment. Alignment change > 0° was considered LOCL. Multiple linear regression analysis was applied to evaluate the association between LOCL and various sagittal parameters at preoperative, such as SCA, CL, T1s and cSVA. Linear regression analysis was applied to evaluate the relationships between LOCL and preoperative SCA in each subgroup.
Patients were assigned to three groups depending on the quartile of preoperative SCA. The first quarter of patients were defined as the low SCA group, the last quarter were defined as the high SCA group and the middle half were defined as the middle SCA group. There was no statistically significant difference in age, sex and the type of OPLL among the three groups. Patients in the low SCA group showed more cervical lordosis before surgery and more LOCL after LAMP (p < 0.001). After linear regression analysis for SCA and LOCL, preoperative SCA was negatively correlated with LOCL in the low SCA group (r = - 0.857, p < 0.001) and high SCA group (r = - 0.515, p = 0.034). However, there was no significant correlation between preoperative SCA and LOCL in the middle SCA group (r = 0.027, p = 0.881).
Patients with lower SCA had more lordosis preoperatively and performed more LOCL after LAMP at 2 years of follow-up. Both too high or low preoperative SCA were negatively correlated with the degree of LOCL, while when the SCA fluctuates in a suitable range, it is easier to compensate for the changes of cervical sagittal alignment.
探讨颅颈倾斜角（SCA）与颈椎前凸丢失（LOCL）的关系，并确定 SCA 是否有能力预测颈椎脊髓病患者的 LOCL。
本研究共选取 68 例接受椎板成形术（LAMP）的颈椎脊髓病患者。C2-C7 前凸被定义为颈椎排列的代表。如果排列变化大于 0°，则认为是 LOCL。采用多元线性回归分析评估 LOCL 与术前各种矢状参数（SCA、CL、T1s 和 cSVA）之间的关系。线性回归分析用于评估 LOCL 与术前 SCA 之间的关系在每个亚组。
根据术前 SCA 的四分位数将患者分为三组。第一组被定义为低 SCA 组，最后一组被定义为高 SCA 组，中间一半被定义为中 SCA 组。三组间患者的年龄、性别和 OPLL 类型无统计学差异。低 SCA 组患者术前颈椎前凸更大，LAMP 后 LOCL 更多（p<0.001）。对 SCA 和 LOCL 进行线性回归分析后，术前 SCA 与低 SCA 组 LOCL 呈负相关（r=-0.857，p<0.001）和高 SCA 组（r=-0.515，p=0.034）。然而，中 SCA 组术前 SCA 与 LOCL 无显著相关性（r=0.027，p=0.881）。
SCA 较低的患者术前前凸更大，LAMP 后 2 年 LOCL 更多。术前 SCA 过高或过低均与 LOCL 程度呈负相关，而当 SCA 在合适范围内波动时，更容易补偿颈椎矢状面排列的变化。
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