摘要
目的:探讨多裂肌萎缩与颈后路单开门术后轴性症状发生的相关性。方法:回顾性分析2017年12月至2019年12月期间我院收治的42例,多节段颈椎管狭窄症或(和)颈椎后纵韧带骨化症,行改良式C3-C6单开门椎管成形术患者的临床资料。所有患者行颈椎MRI检查,使用医星PACS(成都,中国)软件分析,测量患者术前C4、C5、C6 MRI T2像两侧多裂肌横截面积CSA(cross-sectional area),以及末次随访后C4、C5、C6多裂肌横截面积之和FCSA(fat-free cross-sectional area),并计算FCSA/CSA比值的均值评估多裂肌萎缩程度,分析多裂肌萎缩与术后轴性症状发生的相关性。结果:共纳入42位患者,6例出现轴性症状。患者年龄(平均77.17岁)、术前VAS(visual analogue scale)评分(4.17分)明显大于无轴性症状组患者的年龄(平均50.67岁)和术前VAS评分(3.14分),且在轴性症状组中患者FCSA/CSA比值显著低于术后无症状组,差异有统计学意义(P<0.05)。进一步二元Logistic回归分析显示,年龄和患者裂肌萎缩程度为轴性症状发生的危险因素,且年龄每增加1岁,术后轴性症状发生的风险提高16%;FCAS/CAS每上升1%,术后轴性症状发生的风险下降19.4%。结论:患者多裂肌逐步萎缩的过程与术后轴性症状的发生显著负相关,高龄患者术后更容易出现轴向症状。
Objective:To explore the correlation between degree of multifidus muscle atrophy and axial symptoms after cervical single-door surgery.Methods:Patients who were diagnosed as multi-segment cervical spinal stenosis or(and)ossification of the posterior longitudinal ligament of the cervical spine, afterwards underwent modified C3-C6 single open-door laminoplasty between December 2017-December 2019 were included in this study.Multifidus muscle cross-sectional area(CSA)and fat-free multifidus muscle cross-sectional area(FCSA)at C4、C5 and C6 levels were measured by the Cervical MRI.The mean value of FCSA/CSA ratio was calculated to evaluate the degree of multifid atrophy, through which we were able to analyze the correlation between multifidus muscle atrophy and axial symptoms after single open-door laminoplasty.Results:A total of 42 patients were recruited in this study, including 6 with axial symptoms after operation.In the axial symptom group, the patients’ age(77.17 years old)and preoperative VAS(visual analog scale)score(4.17 points)were significantly greater than those in the non-axial symptom group patients’ age(50.67 years old)and preoperative VAS score(3.14 points).The ratio of FCSA/CSA in the axial symptom group was significantly lower than that in the non-axial symptom group, and the difference was statistically significant(P<0.05).Logistic regression analysis showed that age and multifidus muscle atrophy were the risk factors for the occurrence of axial symptoms.For each 1-year increase in patients’ age, the risk of postoperative axial symptoms increased by 16%,and for each 1% increase in FCAS/CAS,the risk of postoperative axial symptoms decreased by 19.4%.Conclusions:The gradual atrophy of the patient’s multifidus muscle is significantly and negatively related to the occurrence of postoperative axial symptoms, and older patients are more likely to have axial symptoms after surgery.
作者
袁晓军
徐文华
林军明
李广
甘心荣
YUAN Xiao-jun;XU Wen-hua;LIN Jun-ming;LI Guang;GAN Xin-rong(Department of Orthopaedic Surgery,The People’s Hospital of Yichun City;The Affiliated Hospital of Yichun University,Yichun 336000,China)
出处
《宜春学院学报》
2022年第12期48-51,共4页
Journal of Yichun University
基金
江西省卫生计生委科技计划项目“颈椎后路术后颈后肌肉容积变化与轴性症状的相关性临床研究”(编号:20197491)。
关键词
颈后路单开门术
轴性症状
多裂肌萎缩
single open-door laminoplasty
axial symptoms
multifidus muscle atrophy
