多节段颈椎前路术后颈椎前凸角丢失的危险因素分析

目的 探索多节段颈椎前路术后颈椎前凸角(cervical lordosis,CL)丢失的危险因素.方法 对105名行多节段颈椎前路手术的患者进行回顾性研究,测量颈椎深部椎旁肌的横截面积(cross-sectional area,CSA),测量患者术前术后CL、T1倾斜角(T1 slope,T1S)、C2～7矢状垂直距离...

Risk factors associated with loss of lordosis after multilevel anterior cervical surgery

Objective To evaluate risk factors associated with the loss of lordosis after multilevel anterior cervical surgery. Methods We retrospectively reviewed 105 patients with cervical myelopathy who received anterior cervical surgery. Preoperative deep paraspinal muscles cross-sectional area (CSA) was evaluated. Cervical alignment assessment included cervical lordosis (CL), T1 slope(T1S), and cervical sagittal vertical axis (cSVA). The recovery rate of the Japanese Orthopedic Association (JOA) score was used to evaluate the effect of cervical spine surgery. The alignment change (^△CL) was used to assign groups for patients: lordosis loss group, lordosis kept group, and lordosis gain group. Results Pearson correlation analysis suggested the alignment changes negatively correlated with preoperative CL and preoperative T1S, and positively with deep flexor CSA. Comparisons among three alignment change groups suggested that a larger T1S, smaller extensor CSA, and smaller flexor CSA were related with lordosis loss. A smaller CL and larger cSVA were related with lordosis gain. The result of multivariate stepwise logistic regression showed that a larger preoperative T1S and a smaller deep flexor CSA were significant risk factors of lordosis loss. Conclusion The results of the present study demonstrated that a larger T1 slope and a smaller deep flexor CSA highly predicted the loss of lordosis for patients with multilevel anterior cervical surgery.