Abstract：
BACKGROUND: Preoperative sagittal alignment is of great significance in the development of spinal deformities, degenerative diseases, preoperative planning, postoperative clinical evaluation, and functional recovery. However, few reports have focused on the difference in preoperative sagittal alignment between patients with ossification of the posterior longitudinal ligament (OPLL) and patients with cervical spondylotic myelopathy (CSM).
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.
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.
摘要：
背景：术前矢状位对准在脊柱畸形的发展中具有重要意义，退行性疾病，术前计划,术后临床评估,功能恢复。然而,很少有报道关注后纵韧带骨化(OPLL)患者和脊髓型颈椎病(CSM)患者术前矢状位的差异。
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。
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。
