| 结合K线分析颈椎后纵韧带骨化患者的颈椎活动度与手术预后的关系 |
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投稿时间：2017-10-29 修订日期：2017-12-23
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| 期刊信息：《中国骨伤》年，第卷，第期，第-页 |
| DOI： |
| 基金项目:中国博士后科学基金 |
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| 中文摘要:目的：探讨结合K线分析颈椎后纵韧带骨化患者的颈椎活动度与手术预后的关系。方法：回顾性分析2014年4月-2017年3月于我科行颈椎后路单开门椎管扩大成形术的42例颈椎后纵韧带骨化（Cervical Ossification of the Posterior Longitudinal Ligament, OPLL）患者。根据后纵韧带骨化与K线的位置关系，患者被分为K线（+）组及K线（-）组。计算术前及术后3个月JOA（Japanese Orthopedic Association）评分和术后3个月JOA改善率评估患者神经功能恢复情况。分别测量术前及术后3个月后纵韧带骨化的侵占率（OPLL Occupation Ratio，OOR）、颈椎生理曲度（Cervical Lordotic Angles,CLA）和颈椎前凸值（Cervical Lordotic Value, CLV）。评估不同的K线分组中，CLV＞0组和CLV≤0组之间患者的术后神经功能恢复之间的联系。结果：K线（+）组和K 线（-）组患者的术前CLA分别为14.7°±9.6°和-6.4°±9.5°（P＜0.05），术后3个月CLA分别为14.0°±8.0°和-1.4±10.4°（P＜0.05），术前JOA评分分别为（10.9±3.2）分和（11.2±2.5）分（P＞0.05），术后3个月JOA评分分别为（14.2±1.8）分和（12.6±2.2）分（P＜0.05），术后3个月JOA改善率分别为（54.7±17.6）%和（25.5±15.7）%（P＜0.05）。K线（+）组中，术后3个月CLV＞0组的患者29例，其术后3个月JOA改善率（52.3±17.2）%，术后3个月CLV≤0组的患者4例，其术后3个月JOA改善率为（72.2±7.8）%，术后3个月CLV≤0组患者的术后3个月JOA改善率明显优于术后3个月CLV＞0组的患者，二者之间差异存在统计学意义（P＜0.05）。结论：无论患者颈椎后纵韧带骨化分类为K线（+）或K线（-），颈椎后路单开门椎管扩大成形手术都能够很好的改善患者的神经症状，尤其K线（+）组的患者，具有较好的预后效果。K线（+）组患者术后3个月CLV＞0时，其术后3个月JOA改善率较术后3个月CLV≤0的患者差。 |
| 【关键词】颈椎 后纵韧带骨化 K线 颈椎活动度 |
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| Combining K-line to analyse relationship between cervical range of motion of patients with cervical ossification of the posterior longitudinal ligament and surgical prognosis |
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| ABSTRACT Objective: To explore relationship between cervical range of motion of patients with cervical ossification of the posterior longitudinal ligament and surgical prognosis combining K-line. Methods: To retrospectively analyse 42 patients with ossification of the posterior longitudinal ligament (OPLL) who unerwent cervical posterior single open door laminoplasty in our department between April 2014 and March 2017. The patients were dividing into K-line (+) group and K-line (-) group according to the position realationship of OPLL and K-line. Preoperative and postoperative 3 months JOA score and postoperative 3 months JOA improvement rate were computed to assess neurological function recovery of patients. The realationship between postoperative neurologic functional recovery in patients of CLV＞0 group and CLV≤0 group was evaluated in different K-line subgroups. The preoperative and the postoperative 3 months OPLL occupation ratio (OOR), cervical lordotic angles (CLA) and cervical lordotic value (CLV) were measured respectively. Results: For the patients in K (+) group and K (-) group, their preoperative CLA were 14.7°±9.6° and -6.4°±9.5°(P<0.05) respectively, postoperative 3 months CLA were 14.0°±8.0° and -1.4±10.4°(P<0.05) respectively, preoperative JOA score were (10.9±3.2) points and (11.2±2.5) points (P>0.05) respectively, postoperative 3 months JOA score were (14.2±1.8) points and (12.6±2.2) points (P<0.05) respectively and postoperative 3 months JOA score improvement rate were (54.7±17.6)% and (25.5±15.7)% (P<0.05) respectively. In the K-line (+) group, there were 29 patients in postoperative 3 months CLV>0 group, their postoperative 3 months JOA score improvement rate was (52.3±17.2)%, and 4 patients in postoperative 3 months CLV≤0 group, their postoperative 3 months JOA score improvement rate was (72.2±7.8)%. The postoperative 3 months JOA score improvement rate of the patients in postoperative 3 months CLV≤0 group was significantly better than that of the patients in postoperative 3 months CLV>0 group and the difference between the two groups has statistical significance (P<0.05) Conclusion: No matter whether OPLL was classified as K-line (+) or K-line (-), the cervical posterior single open door laminoplasty can improve the neurological symptoms of the patients, especially the patients in the K-line (+) group with better prognosis. The patinets in K-line (+) group, when postoperative 3 months CLV>0, their postoperative 3 months JOA score improvement rate is lower than that of the patients with postoperative 3 months CLV≤0. |
| KEY WORDS Cervical Spine Cervical Ossification of the Posterior Longitudinal Ligament (OPLL) K-line Cervical Range of Motion (ROM) |
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