Diao Yuhang, Hu Xiaojun, Hao Mingyu, Xie Minghao, Hao Zhenghao, Li Chenyang, Tan Rui, Rong Hongtao, Zhu Tao
Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, 300000, China.
Neurosurg Rev. 2025 Jan 4;48(1):22. doi: 10.1007/s10143-025-03187-9.
Loss of cervical lordosis (LOCL) is the most common postoperative cervical deformity. This study aimed to identify the predictors of LOCL by investigating the relationship between various factors and LOCL development after surgery for cervical spinal cord tumors. A retrospective analysis was conducted on 51 patients who underwent cervical spinal tumor resection at a single center. Data on the patients' cervical sagittal alignment parameters were collected both pre- and postoperatively to analyze the association between pre- and postoperative cervical sagittal alignment parameters, age, sex, pathological type of tumor, tumor location, tumor length, and likelihood of developing LOCL following cervical spinal cord surgery. Multiple logistic regression analysis revealed significant differences Pre-T1s (p = 0.005) and Post-CL (p = 0.009) angles. Additionally, ROC curves indicated a significant relationship between Post-CL and LOCL (p = 0.008, AUC = 0.718), with a Post-CL threshold value of 9.5°, and a relationship between Pre-T1s and LOCL (p = 0.025, AUC = 0.687). Tumor location, clinical staging, age, sex, and length of the segments involved in the tumor were not significantly associated with LOCL. Patients with a post-CL of less than 9.5° or Pre-T1s of more than 24.5° had a noticeably higher risk of developing LOCL. Active intervention in conjunction with surgical follow-up may be required for patients experiencing significant discomfort and associated functional impairment.
颈椎生理前凸消失（LOCL）是最常见的颈椎术后畸形。本研究旨在通过调查各种因素与颈椎脊髓肿瘤手术后LOCL发生之间的关系，来确定LOCL的预测因素。对在单一中心接受颈椎肿瘤切除术的51例患者进行了回顾性分析。收集患者术前和术后的颈椎矢状位对线参数数据，以分析术前和术后颈椎矢状位对线参数、年龄、性别、肿瘤病理类型、肿瘤位置、肿瘤长度以及颈椎脊髓手术后发生LOCL的可能性之间的关联。多因素逻辑回归分析显示，术前T1s角（p = 0.005）和术后CL角（p = 0.009）存在显著差异。此外，ROC曲线表明术后CL角与LOCL之间存在显著关系（p = 0.008，AUC = 0.718），术后CL角阈值为9.5°，术前T1s角与LOCL之间也存在关系（p = 0.025，AUC = 0.687）。肿瘤位置、临床分期、年龄、性别以及肿瘤累及节段的长度与LOCL无显著关联。术后CL角小于9.5°或术前T1s角大于24.5°的患者发生LOCL的风险明显更高。对于出现明显不适和相关功能障碍的患者，可能需要在手术随访的同时进行积极干预。
