颈椎前路椎间盘切除融合术中不同椎间高度与邻椎病后再手术的相关性OACSTPCD

Objective To investigate the correlation between intervertebral height(IH)during anterior discectomy and fusion(ACDF)for cervical disc herniation and reoperation after adjacent segment disease(ASD).Methods A total of 68 cases of cervical disc herniation treated by operation in Jiangsu Provincial Corps Hospital of Chinese People's Armed Police Force from January 2005 to November 2020 were selected.IH was measured 3 days after ACDF operation and divided into 4 groups according to the value.Preop-erative neutral IH was,130%-140%(group A),141%-150%(group B),151%-160%(group C),and 161%-170%(group D).Follow-up observation was conducted to observe three aspects,the relationship between IH and Cobb improvement angle of operative segment(Cn),C2-7 Cobb improvement angle,thoracic inlet angle(TIA)and T1 slope(T1 S),the IH changes in the upper and lower adjacent segments after ASD,and the effect of different IH on reoperation after ASD.Results The rate of reoperation after ASD in group B was the lowest(7%).Compared with group B,IH in adjacent segments of groups A,C and D significantly decreased(P<0.05),and the difference was statistically significant(P<0.05).Correlation analysis showed that intervertebral height increment(ΔIH)was weakly correlated with the Cobb improvement angle of operative segment(Cn)(r=0.426,P=0.028),but not signifi-cantly correlated with the change of C2-7 Cobb,TIA or T1 S.In group C and group D,the number of reoperation for adjacent segment disease accounted for 71.4%of the total number of reoperations.Conclusions Single gap IH greater than 150%before operation is a high risk factor for the reoperation for ASD.The 140%～150%group is characterized by the least ASD,which is a relatively ideal IH.