一种用于预测椎板成形术治疗的后纵韧带骨化症(OPLL)患者预后的新型后柱压缩评分系统:倾向匹配分析
A Novel Posterior Compression Score System for Outcome Prediction in Laminoplasty Treated OPLL Patients: A Propensity-Matched Analysis.
作者信息
Wei Leixin, Cao Peng, Xu Chen, Hu Bo, Wu Huiqiao, Tian Ye, Chen Huajiang, Shen Xiaolong, Yuan Wen
机构信息
Department of Orthopedic Surgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China.
出版信息
Global Spine J. 2024 Apr;14(3):941-948. doi: 10.1177/21925682221130045. Epub 2022 Sep 26.
STUDY DESIGN
A retrospective observational study.
OBJECTIVE
To describe a novel outcome indication system, the posterior compression score (PCS), and investigate its clinical value in cervical ossification of the posterior longitudinal ligament (OPLL) patients treated with laminoplasty.
METHODS
A total of 282 OPLL patients who underwent laminoplasty from January 2013 to December 2018 were reviewed. The patients were divided into high-score (HS) or low-score (LS) groups based on whether the PCS was over 8. Propensity score matching analysis with a caliper of .1 was used to attenuate the potential selection bias. Clinical measurements, including the Japanese Orthopedic Association (JOA) score, visual analog scale (VAS), neck disability index (NDI), and radiological measurements, including C2-C7 lordotic angle and range of motion (ROM), were compared between the groups.
RESULTS
The mean follow-up period was 29.87 ± 9.17 months. There were no significant differences between the two groups regarding patients' baseline demographical and clinical characteristics after propensity score matching. No significant differences were found in the operative time, blood loss, postoperative VAS score for neck and arm pain, postoperative C2-C7 lordotic angle, or postoperative ROM ( > .05). However, the postoperative JOA score and recovery rate were significantly higher in the HS group than in the LS group, while the postoperative NDI was significantly lower in the HS group ( < .05).
CONCLUSION
OPLL patients with higher PCS scores displayed better clinical outcomes. The novel PCS system is suggested to be a reliable scoring system for surgical outcome evaluation in patients with cervical OPLL.
研究设计
一项回顾性观察研究。
目的
描述一种新的结果指示系统,即后纵韧带压迫评分(PCS),并研究其在接受椎板成形术治疗的后纵韧带骨化症(OPLL)患者中的临床价值。
方法
回顾性分析2013年1月至2018年12月期间接受椎板成形术的282例OPLL患者。根据PCS是否超过8分,将患者分为高分(HS)组或低分(LS)组。采用卡尺为0.1的倾向评分匹配分析来减轻潜在的选择偏倚。比较两组之间的临床测量指标,包括日本骨科协会(JOA)评分、视觉模拟量表(VAS)、颈部功能障碍指数(NDI),以及影像学测量指标,包括C2-C7前凸角和活动范围(ROM)。
结果
平均随访期为29.87±9.17个月。倾向评分匹配后,两组患者的基线人口统计学和临床特征无显著差异。手术时间、失血量、术后颈部和手臂疼痛的VAS评分、术后C2-C7前凸角或术后ROM方面均未发现显著差异(P>0.05)。然而,HS组的术后JOA评分和恢复率显著高于LS组,而HS组的术后NDI显著低于LS组(P<0.05)。
结论
PCS评分较高的OPLL患者临床结局更好。新的PCS系统被认为是评估颈椎OPLL患者手术结局的可靠评分系统。