颈椎前路减压椎间融合器置入对椎间孔孔径的影响

The change of intervertebral foramina in anterior cervical discectomy and fusion

中文关键词:  椎间孔  颈椎病  前路手术  椎间融合器

英文关键词:Foramina  Cervical spondylosis  Anterior operation  Interbody fusion cage

中文摘要:

  【摘要】 目的：探讨颈椎前路减压椎间融合器置入对椎间孔孔径的影响。方法：回顾性分析2016年10月~2017年4月在我院行单节段颈椎前路减压椎间融合器置入术的29例神经根型或脊髓型颈椎病患者，其中男18例，女11例；年龄40~66岁（54.2±6.9岁）；手术节段：C3/4 3例，C4/5 9例，C5/6 17例。将所有患者的术前、术后颈椎CT平扫数据导入Aquarius iNtuition Viewer 4.4进行三维重建，确定测量层面，运用软件所带测量工具对手术节段、上位相邻节段和下位相邻节段双侧椎间孔孔径的相关指标进行测量，包括椎间孔上对角线、下对角线、高度和面积，对术前和术后手术节段、上位相邻节段及下位相邻节段双侧椎间孔的上对角线、下对角线、高度和面积进行统计学分析。结果：术前、术后同一节段双侧椎间孔的测量数据无显著性差异（P>0.05），合并统计。术前手术节段、上位相邻节段及下位相邻节段椎间孔的上对角线和下对角线分别为5.55±0.81mm、5.64±1.00mm、5.48±0.95mm和6.11±0.99mm、5.91±1.02mm、6.07±1.02mm，术后分别5.49±0.92mm、5.73±0.94mm、5.45±0.81mm和6.04±1.06mm、6.06±0.96mm、6.01±1.01mm，术前、术后比较无显著性差异（P>0.05）。术前手术节段、上位相邻节段及下位相邻节段的椎间孔高度和面积分别为8.70±1.08mm、9.60±0.98mm、9.20±1.0mm和0.35±0.08cm2、0.41±0.12cm2、0.36±0.09cm2；术后手术节段、上位相邻节段及下位相邻节段的椎间孔高度和面积分别是9.35±1.02mm、9.02±1.15mm、8.62±1.08mm和0.38±0.08cm2、0.39±0.12cm2、0.34±0.09cm2。术后手术节段椎间孔高度和面积较术前均显著性增大（P<0.05），上位相邻节段和下位相邻节段椎间孔的高度和面积较术前显著性减小（P<0.05）。结论：颈椎前路减压椎间融合器置入可以增大手术节段椎间孔的高度和面积，减小上位相邻节段和下位相邻节段的椎间孔高度和面积。

英文摘要:

  【Abstract】 Objectives: To discuss the change of intervertebral foramina under anterior cervical discectomy and fusion. Methods: Twenty-nine patients with cervical spondylotic radiculopathy or cervical spondylotic myelopathy who were treated with single-level anterior cervical discectomy and fusion from October 2016 to April 2017 were retrospectively reviewed, including 18 males and 11 females with a mean age of 54.2±6.9 years(range, 40-66 years), 3 cases of C3/4 level, 9 cases of C4/5 level and 17 cases of C5/6 level. All the original data were transferred to 3D reconstruction with Aquarius iNtuition Viewer 4.4, the software tools were used to measure the intervertebral foramina related indexes including superior diagonal distance(DSI), inferior diagonal distance(DIS), height(H) and foraminal area(A). The measurements were analyzed statistically for the bilateral foramina of the operation level, cranial and caudal adjacent levels before and after operation. Results: There was no significant difference of the same bilateral foramina measurement in the same level between preoperation and postoperation(P>0.05). Preoperation DSI and DIS in the operation level, cranial and caudal adjacent levels were 5.55±0.81mm, 5.64±1.00mm, 5.48±0.95mm and 6.11±0.99mm, 5.91±1.02mm, 6.07±1.02mm; and postoperation those were 5.49±0.92mm, 5.73±0.94, 5.45±0.81mm and 6.04±1.06mm, 6.06±0.96mm, 6.01±1.01mm. There was no significant difference between preoperation and postoperation(P>0.05). The H and A in the operation level, cranial and caudal adjacent levels before operation were 8.70±1.08mm, 9.60±0.98mm, 9.20±1.00mm and 0.35±0.08cm2, 0.41±0.12cm2, 0.36±0.09cm2. The H and A in the operation level, cranial and caudal adjacent levels after operation were 9.35±1.02mm, 9.02±1.15mm, 8.62±1.08mm and 0.38±0.08cm2, 0.39±0.12cm2, 0.34±0.09cm2. The H and A in the operation level increased significantly(P<0.05), but the cranial and caudal adjacent levels decreased significantly(P<0.05). Conclusions: The anterior cervical discectomy and fusion can increase the H and A in the operation level and decrease the H and A in the cranial and caudal adjacent levels.