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单侧显露通道辅助椎板成形术后颈后椎旁肌体积变化的研究

A Study on the Volume Changes of the Posterior Cervical Paravertebral Muscles After Unilateral Exposure Channel-Assisted Laminoplasty.

作者信息

Zhong Huajian, Xu Chen, Wang Haoyi, Wang Ruizhe, Wei Leixin, Wu Huiqiao, Wang Xinwei, Liu Yang, Chen Huajiang, Yuan Wen, Shen Xiaolong

机构信息

Department of Orthopedics, The Second Affiliated Hospital of Naval Medical University, Shanghai, China.

Department of Orthopedics, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.

出版信息

Global Spine J. 2025 May 5:21925682251340617. doi: 10.1177/21925682251340617.

DOI:10.1177/21925682251340617
PMID:40322794
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12053318/
Abstract

Study DesignRetrospective Cohort Study.ObjectiveThe aim of this study was to evaluate the efficacy of our proposed surgical procedure named unilateral exposure channel-assisted (UCA) laminoplasty in treating degenerative cervical myelopathy (DCM), and the postoperative volume changes of cervical paraspinal muscles.MethodsFrom January 2020 to January 2022, 104 patients with DCM underwent unilateral open-door laminoplasty, among which, 63 patients underwent UCA laminoplasty (UCA group) and 41 patients underwent traditional laminoplasty (LP group). The radiological and clinical parameters as well as postoperative complications were recorded and analyzed before operation and during the follow-up.ResultsThe operation was completed successfully for all patients from both groups, who showed significant but comparable improvement in clinical outcome indicators including mJOA score, Neck pain VAS score, NDI score and radiological indicators including spinal canal diameter and area at the final follow-up compared to pre-operation. When conducting the intra-group comparison, less intraoperative time consumption and blood loss, less postoperative drainage and lower incidence of axial symptoms were observed in patients from UCA group than LP group. Furthermore, we found better preservation of C2-7 cobb angle, cervical curvature index (CCI) and cervical paraspinal muscle on the hinge side in patients underwent UCA laminoplasty than traditional laminoplasty.ConclusionThe UCA laminoplasty showed similar efficacy on alleviating clinical symptoms, and priority on maintaining cervical sagittal balance, minimizing intraoperative invasion, speeding up postoperative rehabilitation, reducing paraspinal muscle atrophy and postoperative axial symptoms when compared with traditional unilateral open-door laminoplasty.

摘要

研究设计

回顾性队列研究。

目的

本研究旨在评估我们提出的名为单侧显露通道辅助(UCA)椎板成形术治疗退行性颈椎脊髓病(DCM)的疗效,以及颈椎椎旁肌的术后体积变化。

方法

2020年1月至2022年1月,104例DCM患者接受了单侧开门椎板成形术,其中63例患者接受了UCA椎板成形术(UCA组),41例患者接受了传统椎板成形术(LP组)。记录并分析术前及随访期间的影像学和临床参数以及术后并发症。

结果

两组所有患者手术均成功完成,与术前相比,末次随访时临床结局指标包括改良日本骨科学会(mJOA)评分、颈部疼痛视觉模拟评分(VAS)、颈椎功能障碍指数(NDI)以及影像学指标包括椎管直径和面积均有显著且相当的改善。组内比较时,UCA组患者术中耗时和出血量更少,术后引流量更少,轴性症状发生率更低。此外,我们发现接受UCA椎板成形术的患者比接受传统椎板成形术的患者在C2 - 7 Cobb角、颈椎曲度指数(CCI)和铰链侧颈椎椎旁肌的保留方面更好。

结论

与传统单侧开门椎板成形术相比,UCA椎板成形术在缓解临床症状方面显示出相似的疗效,在维持颈椎矢状位平衡、减少术中侵袭、加速术后康复、减少椎旁肌萎缩和术后轴性症状方面具有优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a382/12669870/7b0106436a89/10.1177_21925682251340617-fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a382/12669870/f75392864bfe/10.1177_21925682251340617-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a382/12669870/384c06a930fc/10.1177_21925682251340617-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a382/12669870/3f2bf5e481fb/10.1177_21925682251340617-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a382/12669870/548ddc23e76d/10.1177_21925682251340617-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a382/12669870/e9a276424bd8/10.1177_21925682251340617-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a382/12669870/7b0106436a89/10.1177_21925682251340617-fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a382/12669870/f75392864bfe/10.1177_21925682251340617-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a382/12669870/384c06a930fc/10.1177_21925682251340617-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a382/12669870/3f2bf5e481fb/10.1177_21925682251340617-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a382/12669870/548ddc23e76d/10.1177_21925682251340617-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a382/12669870/e9a276424bd8/10.1177_21925682251340617-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a382/12669870/7b0106436a89/10.1177_21925682251340617-fig6.jpg

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本文引用的文献

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Ann Med Surg (Lond). 2023 Sep 7;85(10):4830-4834. doi: 10.1097/MS9.0000000000001278. eCollection 2023 Oct.
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Comparison of Midline Splitting versus Unilateral Open Door Laminoplasty and Its Impact on Patient Outcomes.比较中线劈开术与单侧开门椎管成形术及其对患者预后的影响。
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Paraspinal Sarcopenia is Associated With Worse Patient-Reported Outcomes Following Laminoplasty for Degenerative Cervical Myelopathy.
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