术前C7/T1椎间孔面积对后路单开门椎管扩大成形术治疗脊髓型颈椎病疗效的影响

【摘要】 目的：探究术前C7/T1椎间孔面积对脊髓型颈椎病患者接受后路单开门椎管扩大成形术疗效的影响。方法：回顾性分析2021年9月~2022年9月在我院因脊髓型颈椎病行后路单开门椎管扩大成形术治疗的76例患者,其中男58例、女18例,年龄为64.4±8.5岁。于患者术前颈椎双斜位X线片上测量C7/T1椎间孔面积,根据C7/T1椎间孔面积分为两组：A组,C7/T1椎间孔面积≤平均值（40例）,B组,C7/T1椎间孔面积大于平均值（36例）。收集并比较两组患者的手术时间、术中出血量,两组患者的术前、术后3个月、术后12个月的JOA评分,计算JOA改善率;记录两组患者术后12个月的轴性症状发生情况,采用T检验、方差分析及卡方检验分析术前不同C7/T1椎间孔面积的患者接受颈后路单开门手术治疗后是否存在疗效的差异性。结果：C7/T1椎间孔面积A组为35.2±9.7mm2,B组为65.7±13.1mm2;术前C2~C7 Cobb角A组为14.0°±3.6°,B组为16.0°±5.5°,两组间椎间孔面积和C2~C7 Cobb角有统计学差异（P＜0.05）。手术时间A组127.5±23.6min,B组120.3±32.6min;出血量A组176.8±88.2mL,B组183.6±100.2mL,两组间均无统计学差异（P＞0.05）。术前JOA评分A组10.9±2.0分,B组10.3±2.1分,两组间无统计学差异（P>0.05）。术后3个月JOA评分A组12.8±1.5分,B组14.0±2.2分;术后12个月JOA评分A组14.1±1.5分,B组15.9±1.7分,两组间有统计学差异（P<0.05）。术后3个月、12个月JOA评分改善率两组间有统计学差异（P<0.05）。A、B两组术后12个月的轴性症状发生率分别为42.5%和19.4%,有统计学差异（P<0.05）。结论：术前C7/T1椎间孔面积较大的患者后路单开门椎管扩大成形术后神经功能的恢复更好,JOA改善率更高,术后轴性症状的发生率更低。     

Apoptosis of neurons and oligodendrocytes in the spinal cord of spinal hyperostotic mouse (<Emphasis Type="Italic">twy/twy</Emphasis>): possible pathomechanism of human cervical compressive myelopathy

Introduction  

Cervical compressive myelopathy is the most serious complication of cervical spondylosis or ossification of the posterior longitudinal ligament (OPLL) and the most frequent cause of spinal cord dysfunction. There is little information on the exact pathophysiological mechanism responsible for the progressive loss of neural tissue in the spinal cord of such patients. In this study, we used the spinal hyperostotic mouse (twy/twy) as a suitable model of human spondylosis, and OPLL to investigate the cellular and molecular changes in the spinal cord. Mutant twy/twy mouse developed ossification of the ligamentum flavum at C2–C3 and exhibited progressive paralysis.