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颈椎脊髓病的影像学参数:文献回顾。

Radiographic Parameters in Cervical Myelopathy: Review of Current Literature.

机构信息

Department of Orthopaedic Surgery.

Center for Musculoskeletal Research.

出版信息

Clin Spine Surg. 2022 Dec 1;35(10):389-395. doi: 10.1097/BSD.0000000000001412. Epub 2022 Nov 9.

Abstract

STUDY DESIGN

This was a narrative review.

OBJECTIVES

Provide a comprehensive review of radiographic alignment parameters and their effect on procedure selection, surgical decision-making, and clinical outcomes for the treatment of cervical spondylotic myelopathy (CSM).

SUMMARY OF BACKGROUND DATA

The use of radiographic parameters to predict prognosis and surgical outcomes in patients with CSM is an evolving field given the complex presentation of patients with this condition.

METHODS

A literature search was conducted using PubMed for surgical treatment of CSM, with an emphasis on cervical radiographic parameters and clinical outcomes.

RESULTS

The principal goals of spine surgery can be broken down into decompression, stabilization, and restoration of alignment. The principle of restoring balance takes careful preoperative planning and attention to radiographic parameters including cervical lordosis, C2-C7 sagittal vertical axis, neck tilt, thoracic inlet angle, T1 slope, K-line, and modified K-line. Surgical interventions for CSM include anterior cervical discectomy and fusion, posterior cervical fusion, or laminoplasty and careful consideration of radiographic measures guide surgical decision-making is essential to ensure optimal outcomes.

CONCLUSION

Utilization of key radiographic parameters in surgical planning and decision-making allows surgeons to optimize clinical outcomes for CSM.

LEVEL OF EVIDENCE

Level V.

摘要

研究设计

这是一篇叙述性综述。

目的

全面回顾颈椎脊髓病(CSM)治疗中影像学对线参数及其对手术选择、手术决策和临床结果的影响。

背景资料概要

鉴于该疾病患者的复杂表现,使用影像学参数来预测 CSM 患者的预后和手术结果是一个不断发展的领域。

方法

使用 PubMed 对 CSM 的手术治疗进行了文献检索,重点关注颈椎影像学参数和临床结果。

结果

脊柱手术的主要目标可以分为减压、稳定和恢复对线。恢复平衡的原则需要仔细的术前规划和对线参数的关注,包括颈椎前凸、C2-C7 矢状垂直轴、颈部倾斜度、胸廓入口角、T1 斜率、K 线和改良 K 线。CSM 的手术干预包括前路颈椎间盘切除术和融合术、后路颈椎融合术或椎板切除术,仔细考虑影像学措施指导手术决策对于确保最佳结果至关重要。

结论

在手术规划和决策中使用关键影像学参数可以使外科医生优化 CSM 的临床结果。

证据水平

5 级。

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