两种后路单门颈椎减压手术后颈椎矢状面参数的变化及对轴向症状的影响

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-05-09 DOI:10.1016/j.jocn.2025.111293

Zehua Jiang, Xuanhao Fu, Wenjun Du, Rusen Zhu

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引用次数: 0

摘要

目的评价两种后路单门颈椎减压术对颈椎病患者轴向症状和颈椎矢状面参数的影响。方法回顾性分析2021年1月至2023年1月行手术治疗的185例颈椎病患者的临床资料。患者被分为两组：研究组接受椎板成形术联合C3椎板切除术，对照组接受标准的C3-7单门椎板成形术。根据术后日本骨科协会（JOA）评分、轴向症状发生率和颈椎参数（如活动度（ROM）、颈椎曲度指数（CCI）和C2-7 Cobb角）对两组进行比较。结果两组患者JOA评分及神经功能恢复率无显著差异。与对照组相比，研究组轴状症状的发生率显著降低，分别为22.50%和61.54%。(P & lt;0.05)。术后两组患者CCI均显著降低(P <；0.05)。但研究组CCI改善程度明显高于对照组，差异有统计学意义(P <；0.05)。此外，研究组术后关节活动度和颈椎曲度的损失明显少于对照组(P <；0.05)。结论与传统的单门椎板成形术相比，椎板成形术联合C3椎板切除术能更有效地减压颈椎病患者的神经，同时保持颈椎的结构和功能完整，减少术后轴向症状。该手术入路对于维持颈椎矢状面平衡和功能完整性至关重要。

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Changes in cervical sagittal parameters and the impact on axial symptoms after two types of posterior single-door cervical decompression surgeries

Objective

The present study aimed to assess the impact of two posterior single-door cervical decompression procedures on axial symptoms and cervical sagittal parameters in patients with cervical spondylosis.

Methods

A retrospective study was performed on the clinical records of 185 patients diagnosed with cervical spondylosis who had surgical interventions from January 2021 to January 2023. The patients were categorized into two groups: a study group that underwent laminoplasty combined with C3 laminectomy, and a control group that received the standard C3-7 single-door laminoplasty procedure. The groups were compared based on postoperative Japanese Orthopaedic Association (JOA) scores, incidence of axial symptoms, and cervical parameters such as range of motion (ROM), cervical curvature index (CCI), and C2-7 Cobb angle.

Results

No notable differences were observed in JOA scores and the rates of neurological function recovery between the groups. The occurrence of axial symptoms was markedly reduced in the study group when compared to the control group, with rates of 22.50 % and 61.54 %, respectively.(P < 0.05). Postoperatively, a significant reduction in CCI was observed in both groups (P < 0.05). However, the study group showed a markedly more substantial improvement in CCI than the control group, with the difference reaching statistical significance (P < 0.05). Additionally, the study group showed significantly less loss of ROM and cervical curvature than the control group post-surgery (P < 0.05).

Conclusion

Compared to conventional single door laminoplasty, laminoplasty with C3 laminectomy more effectively decompresses nerves in patients with cervical spondylosis while preserving the structural and functional integrity of the cervical spine and minimizing postoperative axial symptoms. This surgical approach is crucial for maintaining cervical sagittal balance and functional integrity.

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.