摘要
Abstract
Objective To evaluate the impact of preoperative cervical sagittal parameters on the loss of cervical lordosis(LCL)after expansive open-door laminoplasty(EOLP)and explore the optimal predictors.Methods A retrospective analysis was performed on the clinical data of 94 patients with cervical spondylotic myelopathy who underwent EOLP from January 2019 to January 2021,including 61 males and 33 females,aged 34 to 75 years old with an average age of(53.1±9.7)years old.Pre-operative routine anteroposterior,lateral,and dynamic X-ray films of the cervical and thoracic spine were taken to comprehen-sively assess various cervical sagittal parameters:T1 slope(T1S),C2-C7 sagittal vertical axis(C2-C7 SVA),C2-C7 cervical lor-dosis(CL),T1 slope-cervical lordosis(T1S-CL),cervical lordosis/T1 slope(CL/T1S),C2-C7 cervical range of motion(ROM),thoracic kyphosis(TK),cephalad vertebral level undergoing laminoplasty(CVLL),and C2,3 disc angle.Statistical analysis was conducted to identify the independent risk factors of preoperative sagittal parameters for postoperative LCL.Results A total of 94 patients meeting the inclusion and exclusion criteria were enrolled,with a postoperative follow-up period of 12 to 24 months.Pearson correlation analysis showed that T1S,T1S-CL,CVLL,and C2,3 disc angle were significantly correlated with postopera-tive LCL,while C2-C7 SVA,CL,CL/T1S,C2-C7 ROM,and TK had no significant correlation with postoperative LCL.Regression analysis further indicated that T1S(β=0.426,P＜0.001),T1S-CL(β=0.716,P＜0.001),C2,3 disc angle(β=0.351,P＜0.001),and CVLL(β=-3.348,P＜0.001)were significantly correlated with postoperative LCL.Conclusion For patients with cervical spondylotic myelopathy treated with EOLP,T1S,T1S-CL,CVLL,and C2,3 disc angle are important factors for predicting cervical lordosis loss,among which CVLL may be the most critical predictive indicator.关键词
脊髓型颈椎病/单开门椎板成形术/颈椎曲度/矢状位参数/相关性分析/最佳预测因子Key words
Cervical spondylotic myelopathy/Expansive open-door laminoplasty/Cervical lordosis/Sagittal pa-rameters/Correlation analysis/Best predictive factors分类
医药卫生
