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  • 苏启航,陈 涛,张 岩,等.单节段颈前路椎间盘切除植骨融合术后颈椎椎间高度和整体曲率的影像学变化[J].同济大学学报(医学版),2020,41(1):100-106.    [点击复制]
  • SU Qi-hang,CHEN Tao,ZHANG Yan,et al.Cervical intervertebral height and whole curvature changes after single level anterior cervical discetomy fusion: a radiological study[J].同济大学学报(医学版),2020,41(1):100-106.   [点击复制]
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单节段颈前路椎间盘切除植骨融合术后颈椎椎间高度和整体曲率的影像学变化
苏启航,陈涛,张岩,张锦飙,谭军,郭松
0
(同济大学附属东方医院骨科,上海 200120; 平湖市第二人民医院骨科,浙江 平湖 314200)
摘要:
目的 本研究旨在探讨单节段颈椎前路椎间盘切除减压植骨融合术(anterior cervical discectomy and fusion, ACDF)后颈椎椎间高度及颈椎整体曲度的变化。方法 回顾性分析接受单节段ACDF治疗的119名脊髓型颈椎病患者的病例及影像学资料。通过使用患者的颈椎X线平片测量融合前后椎间隙的高度。同时测量侧位片上第2颈椎至第7颈椎的Cobb角,以评估颈椎的整体曲度。通过比较术前和术后的影像学资料,以说明置入椎间融合器对颈椎椎间高度和整体曲度的影响。结果 术后神经功能JOA及Nurick评分较术前明显改善(P<0.01)。术前椎间前高度(anterior intervertebral height, AIH)和椎间后高度(posterior intervertebral height, PIH)均明显低于正常椎间高度(P<0.01),术后AIH明显升高,恢复正常;术后PIH与术前相比同样明显增加。术后颈椎曲度[(22.36±5.07)°]较术前[(16.53±6.85)°]明显增加(P<0.01),但是并未恢复至正常曲度。结论 ACDF手术能够完成有效的神经减压改善神经功能,并且该手术能够恢复颈椎退变节段的椎间高度及改善颈椎整体曲度。
关键词:  脊髓型颈椎病  颈前路椎间盘切除植骨融合术  影像学研究  椎间隙高度  颈椎整体曲度
DOI:10.16118/j.1008-0392.2020.01.018
投稿时间:2019-07-18
基金项目:国家重点研发计划项目(2017YFA0105404)
Cervical intervertebral height and whole curvature changes after single level anterior cervical discetomy fusion: a radiological study
SU Qi-hang,CHEN Tao,ZHANG Yan,ZHANG Jin-biao,TAN Jun,GUO Song
(Dept. of Orthopedics, East Hospital, Tongji University School of Medicine, Shanghai 200120, China;Dept. of Orthopedics, East Hospital, Tongji University School of Medicine, Shanghai 200120, China; Dept. of Orthopedics, Second People’s Hospital, Pinghu 314200, Zhejiang Province, China)
Abstract:
Objective To examine the changes of cervical intervertebral height and whole cervical curvature after single level anterior cervical discectomy fusion(ACDF). Methods The clinical and radiological data of 119 patients with single level cervical spondylotic myelopathy undergoing ACDF treatment were retrospectively reviewed. The intervertebral heights were measured on X-ray films before and after fusion. Cobb angles from C2 to C7 on lateral view radiography were also measured to estimate whole cervical lordosis. The effect of cervical cage placement on cervical intervertebral height and whole cervical curvature was analyzed. Results Both the JOA score and Nurick’s score were improved after ACDF treatment(P<0.05). The preoperative anterior intervertebral height(AIH) and posterior intervertebral height(PIH) were significantly lower than those in of normal intervertebral height(P<0.01). Following operation, AIH increased significantly and returned to the normal; the postoperative PIH were also significantly increased compared with preoperative PIH. Additionally, postoperative cervical curvature(22.36±5.07)° was significantly increased compared with the preoperative curvature(16.53±6.85)°(P<0.01). Conclusion ACDF can achieve the effective spinal cord decompression in treatment of single level cervical spondylotic myelopathy, and it can also restore the intervertebral height and increase the entire cervical curvature.
Key words:  cervical spondylotic myelopathy  anterior cervical discectomy with interbody fusion  radiological study  intervertebral height  entire cervical curvature

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