Health Management Center, The Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, PR China.
Department of Radiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Shandong, PR China.
Medicine (Baltimore). 2022 Feb 4;101(5):e28743. doi: 10.1097/MD.0000000000028743.
The appearance of atherosclerosis in the carotid artery may be suggest the possibility of atherosclerosis in the spinal cord artery, which can cause spinal cord ischemia and further lead to neural element damage.According to the inclusion and exclude standard, there are 137 patients with cervical spondylotic myelopathy (CSM) incorporating retrospective analysis. These patients were consecutively admitted into The Second Hospital- Cheeloo College of Medicine-Shandong University from January 2016 to December 2018 and have accepted surgical treatment. All patients were examined by color Doppler ultrasound to detect carotid atherosclerosis before surgery. All patients were divided into 2 groups according to the presence or absence of carotid atherosclerosis: carotid atherosclerosis group (n = 88) and noncarotid atherosclerosis group (n = 49). All patients were followed up for at least 12 months after surgery. Demographic and surgery-related data were collected and analyzed to identify potential factors that affect the surgical outcomes in CSM.The average age of carotid atherosclerosis group (51 males and 37 females), and noncarotid atherosclerosis group (24 males and 25 females) were 62.02 ± 10.34 years (range, 38-85 years) and 49.61 ± 10.28 years (range, 26-67 years), respectively.In carotid atherosclerosis group: pre and postoperative modify Japanese Orthopedic Association Scores (mJOA score) were 11.58 ± 1.82 and 14.36 ± 1.64; the recovery rate of mJOA score was 45.57% ± 13.28%. In noncarotid atherosclerosis group: pre and postoperative mJOA score were 12.00 ± 2.11 and 15.04 ± 1.70; the recovery rate of mJOA score was 53.90% ± 13.22%. Univariate logistic regression analysis demonstrated that gender (P = .004), age ≥65 years (P = .001), duration of symptoms ≥12 months (P = .040), smoking history (P < .001), preoperative mJOA score ≤11 (P = .007) and carotid atherosclerosis (P = .004) were related to poor surgical outcomes. Multivariate logistic regression analysis showed significant correlations between poor surgical outcomes and age ≥65 years (P = .047), smoking history (P = .010), preoperative mJOA score ≤11 (P = .008) or carotid atherosclerosis (P = .047).Carotid atherosclerosis may be a risk factor for poor surgical outcomes in CSM.
颈动脉粥样硬化的出现可能提示脊髓动脉粥样硬化的可能性，这可能导致脊髓缺血，进一步导致神经元素损伤。根据纳入和排除标准，对 2016 年 1 月至 2018 年 12 月连续纳入山东大学第二医院-齐鲁医学院的 137 例颈椎病合并回顾性分析。所有患者均在术前接受彩色多普勒超声检查，以检测颈动脉粥样硬化。根据是否存在颈动脉粥样硬化，所有患者均分为 2 组：颈动脉粥样硬化组（n=88）和非颈动脉粥样硬化组（n=49）。所有患者均在术后至少随访 12 个月。收集并分析人口统计学和手术相关数据，以确定影响颈椎病手术结果的潜在因素。
颈动脉粥样硬化组（51 名男性和 37 名女性）和非颈动脉粥样硬化组（24 名男性和 25 名女性）的平均年龄分别为 62.02±10.34 岁（范围 38-85 岁）和 49.61±10.28 岁（范围 26-67 岁）。
术前和术后改良日本矫形协会评分（mJOA 评分）分别为 11.58±1.82 和 14.36±1.64；mJOA 评分的恢复率为 45.57%±13.28%。在非颈动脉粥样硬化组：术前和术后 mJOA 评分分别为 12.00±2.11 和 15.04±1.70；mJOA 评分的恢复率为 53.90%±13.22%。单因素逻辑回归分析表明，性别（P=0.004）、年龄≥65 岁（P=0.001）、症状持续时间≥12 个月（P=0.040）、吸烟史（P<0.001）、术前 mJOA 评分≤11（P=0.007）和颈动脉粥样硬化（P=0.004）与手术结果不良相关。多因素逻辑回归分析显示，年龄≥65 岁（P=0.047）、吸烟史（P=0.010）、术前 mJOA 评分≤11（P=0.008）或颈动脉粥样硬化（P=0.047）与手术结果不良显著相关。
颈动脉粥样硬化可能是颈椎病手术结果不良的危险因素。
