OBJECTIVE: To compare preoperative sagittal alignment between patients with multisegment cervical OPLL and multilevel CSM.
METHODS: Retrospective study.
METHODS: A total of 243 patients were included in this study.
METHODS: The outcome measures were the Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score, number of hand actions in 10 seconds, hand-grip strength, C2 to C7 Cobb angle, C2 to C5 Cobb angle, C5 to C7 Cobb angle, C2 to C7 sagittal vertical axis, C7 slope, T1 slope, K-line, K-line tilt, and range of motion (ROM).
METHODS: The outcome measures were calculated in the OPLL group and CSM group and the data were analyzed using the unpaired t-test, χ² test, and one-way analysis of variance.
RESULTS: A total of 243 patients (136 men, 107 women; mean age, 59.1±10.6 years) underwent surgical treatment from September 2013 to December 2021. In total, 123 patients were diagnosed with multisegment cervical OPLL, including continuous type (n=39), segmental type (n=38), and mixed type (n=46). The remaining 120 patients had multisegment CSM. The disease course in the OPLL group was significantly shorter than that in the CSM group (p<.05). Among the above preoperative measurements, the JOA score, number of hand actions in 10 seconds, hand-grip strength, and VAS score were not significantly different between the two groups (p>.05). The C2 to C7 Cobb angle was significantly larger in the OPLL than CSM group (17.7°±9.2° and 14.9°±9.3°, respectively; p< .05), as was the C5 to C7 Cobb angle (10.0°±6.3° and 7.5°±6.1°, respectively; p<.05). The ROM was significantly smaller in the OPLL than CSM group (33.1°±8.1° and 40.1°±10.9°, respectively; p<.001). Within the OPLL group, the ROM was significantly smaller in the continuous type than in the segmental type (p<.05).
CONCLUSIONS: Patients with multisegment cervical OPLL have greater lordotic preoperative sagittal alignment and smaller preoperative ROM than patients with CSM.
目的:比较多节段颈椎OPLL和多节段CSM患者的术前矢状面对准。
方法:回顾性研究。
方法:本研究共纳入243例患者。
方法:结果测量是日本骨科协会(JOA)评分,视觉模拟量表(VAS)评分,10秒内的手部动作次数,握力,C2-C7Cobb角,C2-C5Cobb角,C5-C7Cobb角,C2-C7矢状垂直轴,C7斜坡,T1斜率,K线,K线倾斜,和运动范围(ROM)。
方法:计算OPLL组和CSM组的结局指标,并使用非配对t检验对数据进行分析,χ²检验,和单向方差分析。
结果:共有243名患者(136名男性,107名妇女;平均年龄,59.1±10.6年)从2013年9月至2021年12月接受了手术治疗。总的来说,123例患者诊断为多节段宫颈OPLL,包括连续型(n=39),节段型(n=38),混合型(n=46)。其余120例患者患有多段CSM。OPLL组病程明显短于CSM组(p<0.05)。在上述术前测量中,JOA得分,10秒内的手部动作次数,握力,两组间VAS评分差异无统计学意义(p>0.05)。OPLL组的C2-C7Cobb角明显大于CSM组(17.7°±9.2°和14.9°±9.3°,分别为;p<0.05),C5-C7Cobb角(10.0°±6.3°和7.5°±6.1°,分别为;p<0.05)。OPLL组的ROM明显小于CSM组(33.1°±8.1°和40.1°±10.9°,分别为;p<0.001)。在OPLL组内,连续型的ROM明显小于节段型(p<0.05)。
结论:与CSM患者相比,宫颈多节段OPLL患者术前前凸矢状位排列更大,术前ROM更小。