| 王豪,陈晶,马一行,朱庆三.严重颈椎后纵韧带骨化症椎管占位率与术后C5神经根麻痹的关系[J].脊柱外科杂志,2018,16(1):31-34. |
严重颈椎后纵韧带骨化症椎管占位率与术后C5神经根麻痹的关系  点此下载全文 (Fulltext) |
| 王豪 陈晶 马一行 朱庆三 |
| 吉林大学中日联谊医院骨科, 吉林 130000 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2018.01.007 |
| 摘要点击次数: 1317 |
| 全文下载次数: 766 |
| 摘要： |
| 目的 探讨严重颈椎后纵韧带骨化症（OPLL）患者颈椎后路双开门椎管扩大椎板成形术后C5神经根麻痹的发生率与椎管占位率的关系。方法 回顾性分析本院2014年1月-2017年1月采用颈椎后路双开门椎管扩大椎板成形术治疗的44例严重OPLL患者（椎管占位率> 50%）的临床资料。以术后是否发生C5神经根麻痹将患者分为麻痹组（11例）和非麻痹组（33例）。所有患者进行影像学检查，测量并记录患者椎管占位率，累及椎体数量，OPLL分型，术前、术后Cobb角和神经功能日本骨科学会（JOA）评分，并计算Cobb角和JOA评分改善率。采用t检验分析以上因素组间差异是否有统计学意义，对差异有统计学意义的因素采用Spearman相关分析和Logistic回归分析评价其与C5神经根麻痹的相关性。结果 t检验结果显示2组间椎管占位率、术前JOA评分、术后JOA评分及JOA评分改善率差异有统计学意义（P < 0.05），纳入相关分析。Spearman相关分析结果显示椎管占位率与术后C5神经根麻痹呈正相关；术前、术后JOA评分及JOA评分改善率与术后C5神经根麻痹呈负相关。Logistic回归分析只有椎管占位率进入方程，椎管占位率与术后C5神经根麻痹具有相关性。结论 严重颈椎OPLL患者术后C5神经根麻痹发生率较高。椎管占位率与术后C5神经根麻痹呈正相关，椎管占位率越高，C5神经根麻痹发生率越高。 |
| 关键词：颈椎 骨化,后纵韧带 椎管狭窄 神经根病 减压术,外科 手术后并发症 |
| Correlation between vertebral canal occupying ratio of severe cervical ossification of posterior longitudinal ligament and postoperative C5 palsy Fulltext |
| WANG Hao CHEN Jing MA Yi-hang ZHU Qing-san |
| Department of Orthopaedics, China-Japan Hospital, Jilin University, Changchun 130000, Jilin, China |
| Fund Project: |
| Abstract: |
| Objective To investigate the relationship between the incidence of C5 palsy and the vertebral canal occupying ratio after posterior cervical double open-door laminoplasty in severe cervical ossification of the posterior longitudinal ligament(OPLL).Methods From January 2014 to June 2017,a total of 44 patients with severe OPLL(vertebral canal occupying rate > 50%) were divided into 2 groups according to whether has postoperative C5 palsy:11 in palsy group and 33 in non-palsy group. All the patients underwent imaging examination. The vertebral canal occupying ratio,the number of vertebrae involved,OPLL classification,preoperative and postoperative Cobb's angles and Japanese Orthopaedic Association(JOA) scores for neurological funcion were measured and recorded. And the improvement rate of Cobb's angle and JOA score were calculated. The t test was used to analyze whether the differences in above factors between the 2 groups were statistically significant. Spearman correlation analysis and Logistic regression analysis were used to evaluate the correlation between statistically different factors and postoperative C5 palsy.Results The results of t test showed that there were significant differences between the 2 groups in vertebral canal occupying ratio,preoperative JOA score,postoperative JOA score and improvement rate of JOA score(P < 0.05),which were included in the correlation analysis. Spearman correlation analysis showed that vertebral canal occupying ratio was positively correlated with postoperative C5 palsy. Preoperative and postoperative JOA scores and improvement rate of JOA score were negatively correlated with postoperative C5 palsy. Logistic regression analysis showed that only vertebral canal occupying ratio entered the equation,and the vertebral canal occupying ratio was associated with postoperative C5 palsy.Conclusion The incidence of postoperative C5 palsy is higher in patients with severe cervical OPLL. The vertebral canal occupying ratio is positively correlated with postoperative C5 palsy. The higher the vertebral canal occupying ratio,the higher the incidence of postoperative C5 palsy. |
| Keywords:Cervical vertebrae Ossification of posterior longitudinal ligament Spinal stenosis Radiculopathy Decompression,surgical Postoperative complications |
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