青年颈椎病手术患者人群特征及其与颈椎间盘退变的相关性

Population characteristics of young patients underwent surgery for cervical spondylosis and their correlation with cervical intervertebral disc degeneration

中文关键词:  颈椎病  青年人群  颈椎间盘退变

英文关键词:Cervical spondylosis  The youth  Cervical disc degeneration

中文摘要:

  【摘要】 目的：分析青年颈椎病手术患者的人群特点及其与颈椎间盘退变（cervical disc degeneration，CDD）程度之间的关系。方法：回顾性收集2010年9月~2020年9月在宁波市第六医院因颈椎病行手术治疗且年龄为18~40周岁的患者资料。统计患者性别、年龄、体质指数（body mass index，BMI）、是否吸烟、饮酒不良嗜好、是否从事长期低头职业、术前VAS评分、手术节段、不同年份全院颈椎手术量等资料。根据术前颈椎X线片中椎间隙高度丢失、椎体前方骨赘、是否存在终板硬化三个指标对CDD严重程度进行评分。采用Spearman相关系数评估患者CDD及三个评分指标与年龄、性别、BMI、吸烟饮酒不良嗜好、长期低头职业、术前颈痛视觉模拟评分（visual analogue scale，VAS）各因素的相关性。结果：符合纳入标准的患者108例，其中男性62例，女性46例，年龄33.9±4.2岁，BMI为25.02±2.40kg/m2。吸烟患者28例，饮酒患者39例，从事长期低头职业的患者为68例。青年颈椎病手术量占当年我院颈椎手术量的比例由2010年的5.6%上升至2020年的8.5%。青年手术人群中CDD总分为2.73±1.20分，以轻度退变居多。93.5%的患者存在椎体间隙高度丢失，62.9%的患者椎体前方有骨赘形成，有终板硬化的患者占50.9%。患者CDD总分与年龄和吸烟两个因素呈中度相关（rs分别为0.41和0.69，P＜0.01），与其他因素无显著相关（P＞0.05）。椎间隙高度丢失评分与年龄和从事长期低头职业呈中等强度正相关（rs分别为0.53和0.41；P＜0.01），与其他因素无显著相关（P＞0.05）。椎体前方骨赘形成评分与年龄和吸烟呈中等强度正相关（rs分别为0.51和0.58；P＜0.01），与其他因素无显著相关（P＞0.05）。终板硬化评分与年龄和吸烟呈中等强度正相关（rs分别为0.31 和0.54；P＜0.01），与其他因素无显著相关（P＞0.05）。结论：青年颈椎病手术患者中CDD退变程度相对较轻，影像表现依次以椎间隙高度丢失、骨赘形成及终板硬化多见，其中椎间隙高度丢失、骨赘形成分别与长期低头职业、吸烟呈现一定相关性。

英文摘要:

  【Abstract】 Objectives: To analyze the population characteristics of young patients underwent surgery for cervical spondylosis and their correlation with the degree of cervical disc degeneration (CDD). Methods: The patients between 18-40 years old who underwent surgery for cervical spondylosis in Ningbo No.6 Hospital from September 2010 to September 2020 were retrospectively collected. Statistics were made on the gender, age, body mass index (BMI), preoperative VAS score for neck pain, smoking or not, drinking or not, phobbing occupation or not, preoperative VAS score for neck pain, operation segments, operation numbers in different years were recorded. The score of CDD was evaluated by three indexes as following: the loss of height loss of intervertebral space, osteophytes in front of vertebral body and endplate sclerosis. Spearman correlation coefficient was used to evaluate the correlations between CDD orits three indexes and the parameters including age, gender, BMI, smoking, drinking, phobbing occupation, VAS score of neck pain. Results: A total of 108 young patients who met the inclusion criteria were treated in the past 10 years, including 62 males and 46 females, with an age of 33.9±4.2 years and a BMI of 25.02±2.40kg/m2. There were 28 patients with smoking habits, 39 patients with alcohol consumption history and 68 patients with long-term phobbing occupation. The proportion of cervical surgery in young patients of the year increased from 5.6% in 2010 to 8.5% in 2020. The total score of CDD in young patients undergoing surgery was 2.73±1.20, and most of whom were of mild degeneration. Loss of vertebral space height was observed in 93.5% of patients, osteophytes in the anterior vertebral body was observed in 62.9% of patients, and endplate sclerosis was observed in 50.9% of patients. The total CDD score was moderately correlated with age and smoking habits(rs=0.41 and 0.69 respectively, P<0.01), with no significant correlation with other factors(P＞0.05). The intervertebral height loss score was moderately correlated with age and long-term phobbing occupation(rs=0.53 and 0.41 respectively, P<0.01), the it had no significant correlation with other factors(P＞0.05). The score of osteophytes in anterior vertebral body was moderately positively correlated with age and smoking (rs=0.51 and 0.58 respectively, P<0.01), but not with other factors (P>0.05). The endplate sclerosis score was moderately positively correlated with age and smoking (rs=0.31 and 0.54 respectively, P<0.01), but there was no significant correlation with other factors(P>0.05). Conclusions: The majority CDD score in young patients underwent surgery for cervical spondylosiswas mild degeneration, the imaging results were followed as height loss, osteophytes and endplate sclerosis. The loss of intervertebral height and the formation of osteophytes were positively correlated with long-term phobbing occupation and smoking.