Does snake-eye appearance affect the clinical outcome of ACDF in treating cervical myelopathy.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

European Spine Journal Pub Date : 2024-11-08 DOI:10.1007/s00586-024-08451-y

Baifeng Sun, Aochen Xu, Cheng Cui, Zichuan Wu, Wenchao Zhou, Min Qi, Yang Liu

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引用次数: 0

Abstract

Purpose: To explore the impact of the snake-eye appearance (SEA) on the efficacy of anterior cervical discectomy and fusion (ACDF) in treating Degenerative Cervical Myelopathy (DCM).

Methods: A total of 316 Patients were divided into three groups, those with SEA were in the SEA group, and those with the absence of SEA were in the non-SEA group. Meanwhile, in the non-SEA group, patients with grade 1 or 2 increased signal intensity (ISI) on T2-weighted MRI were in the ISI group, and the remaining patients without ISI were in the non-ISI group. The modified Japanese Orthopaedic Association scale (mJOA) and the neurologic functional improvement rate (IR) were measured. The number of patients who achieved upper-limb motor weakness improvement was recorded and compared. Propensity score matching (PSM) was used among the three groups.

Results: The postoperative JOA and IR were similar in the SEA and non-SEA group; however, they were significantly lower than in the non-ISI group after PSM(P < 0.05). Besides, only 32.1% of patients in the SEA obtained an improvement of upper-limb motor weakness, which was the lowest in three groups after PSM (60.7% in the non-SEA group and 78.6% in the non-ISI group, P < 0.05).

Conclusions: We suggested that patients with SEA tend to achieve an inadequate neurological recovery after ACDF. Besides, a SEA may be an unfavorable prognostic factor for upper extremity motor function recovery.

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蛇眼外观是否会影响 ACDF 治疗颈椎病的临床效果？

目的：探讨蛇眼外观（SEA）对前路颈椎椎间盘切除及融合术（ACDF）治疗退行性颈椎病（DCM）疗效的影响：将316名患者分为三组，有SEA的患者为SEA组，无SEA的患者为非SEA组。同时，在非 SEA 组中，T2 加权核磁共振成像信号强度（ISI）1 级或 2 级增高的患者为 ISI 组，其余无 ISI 的患者为非 ISI 组。测量改良日本骨科协会量表（mJOA）和神经功能改善率（IR）。记录并比较了上肢运动无力得到改善的患者人数。在三组患者中采用倾向得分匹配法（PSM）：结果：SEA组和非SEA组的术后JOA和IR相似，但PSM（P 结论：SEA组和非SEA组的术后JOA和IR明显低于非ISI组：我们认为 SEA 患者在 ACDF 术后的神经功能恢复往往不够理想。此外，SEA可能是上肢运动功能恢复的不利预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Spine Journal 医学-临床神经学

CiteScore

4.80

自引率

10.70%

发文量

373

审稿时长

2-4 weeks

期刊介绍： "European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts. Official publication of EUROSPINE, The Spine Society of Europe