在长度部融合中,避免第七椎是有意义和必要的吗?
Jung Jae Lee1, Hong Kyung Shin, Sang Ku Jung
1The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Department of Neurological Surgery, Uijeongbu, Republic of Korea.
Turkish neurosurgery
|June 14, 2024
概括
与C7相比,在C6结束的多层次后宫融合 (PCF) 导致部疼痛减少,脊柱对齐更好. 在PCF手术中包括C7可能会加剧宫结核病并影响整个脊柱对齐.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 整形外科 整形外科 整形外科
- 神经外科 神经外科
背景情况:
- 多层子宫后融合 (PCF) 是一种常见的手术,用于椎退行性脊柱疾病.
- 选择远端融合水平,特别是是否包括C7,可能会影响临床和放射性结果.
研究的目的:
- 为了比较经过多级PCF的患者的临床和放射性结果,C6与C7作为远端融合水平.
- 评估将C7纳入PCF对宫对齐,部疼痛和全球脊柱参数的影响.
主要方法:
- 在2012年5月至2020年12月期间,对52名患者进行了退行性疾病的3级或以上PCF的回顾性审查.
- 根据距离融合水平,患者被分为两组:C6 (组1) 和C7 (组2).
- 临床 (部疼痛通过VAS) 和放射性参数 (C2-C7SVA,TK,T9脊倾斜) 在至少两年的随访中进行了比较.
主要成果:
- 组1 (C6融合) 在最后的随访 (p=0.03) 显示与组2 (C7融合) 相比,部视觉模拟尺度 (VAS) 得分明显较低.
- 在放射学上,2组与1组相比,显示出明显更高的C2-C7斜垂直轴 (SVA) 值 (p=0.02),下胸部 (TK) (p=0.03) 和更大的T9脊骨盆倾斜度 (p=0.01).
结论:
- 在多层PCF手术中包括C7与宫结核病的恶化和部疼痛的增加有关.
- 将融合扩展到C7可以对胸脊柱参数和全球脊柱对齐产生负面影响.
- 选择C6作为远端融合水平可能会导致在接受PCF的患者中获得优异的临床和放射性结果.
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