Intervertebral Foramen Width Is an Important Factor in Deciding Additional Uncinate Process Resection in ACDF-a Retrospective Study.
Intervertebral Foramen Width Is an Important Factor in Deciding Additional Uncinate Process Resection in ACDF-a Retrospective Study.
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椎间孔宽度是决定 ACDF 附加钩突切除的重要因素——一项回顾性研究
DOI：
10.3389/fsurg.2021.626344
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发表时间：
2021
影响因子：
1.8
通讯作者：
Liu Y
中科院分区：
文献类型：
--
作者：
Sun B;Xu C;Zhang Y;Wu S;Wu H;Zhang H;Shen X;Zhang Z;Yuan W;Liu Y
背景：颈椎前路髓核摘除融合术(ACDF)是治疗神经根型颈椎病的经典术式。然而，目前尚不清楚联合钩突切除术(UPR)是否有必要治疗神经根型颈椎病。在这里，我们研究了ACDF联合UPR与单纯ACDF治疗神经根型颈椎病的临床结果，以确定UPR治疗神经根型颈椎病的必要性。假设：某些患者可能需要联合钩突切除和ACDF，以获得更好的临床疗效。患者和方法：55例ACDF患者接受UPR治疗，126例未行UPR治疗。用45°斜位X线机测量椎间孔的宽度和高度。我们还测量了日本骨科协会(JOA)评分和视觉模拟评分(VAS)。所有患者术前、术后测量C2-C7 Cobb角。同时，采用线性回归分析评价临床疗效与术前椎间隙宽度的关系。结果：直线回归分析显示，ACDF+UPR组的JOA和VAS评分的改善与术前椎间隙宽度(WIVF)和椎间隙高度(HIVF)无关。然而，在单纯ACDF组中，术前wIVF与术后JOA和VAS评分相关。ACDF组术前wIVF>3 mm的患者术后临床症状改善最少(P>；0.05)。WIVF>3 mm的ACDF组与ACDF+UPR组的临床结局相似，术后WIVF显著增加(P<；0.05)。两组融合率及C2-C7 Cobb角差异无统计学意义(P>；0.05)。讨论：我们目前的研究结果表明，当WIVF的术前直径为3 mm时，应考虑UPR。但ACDF术前WIVF>3 mm时，不需要牺牲钩椎关节。证据级别：三级。
Background: Anterior cervical discectomy and fusion (ACDF) has been established as a classic procedure for the management of cervical radiculopathy. However, it is unclear whether combined uncinate process resection (UPR) is necessary for treating cervical radiculopathy. Here, we investigated the clinical outcome of ACDF combined with UPR compared to ACDF alone to determine the necessity of UPR in treating cervical radiculopathy. Hypothesis: Uncinate process resection may be necessary in certain patients along with ACDF to achieve better clinical outcomes of cervical radiculopathy. Patients and Methods: Fifty-five patients underwent ACDF with UPR, and 126 patients without UPR were reviewed. The width and height of the intervertebral foramen were measured by 45° oblique X-rays. We also measured the Japanese Orthopedic Association (JOA) score and visual analog scale (VAS) score. C2–C7 Cobb angles were obtained from all patients pre- and post-operatively. Meanwhile, linear regression analysis was used to evaluate the relationship between the clinical outcomes and the intervertebral foramen width before surgery. Results: Linear regression analysis indicated that the improvement in the JOA and VAS scores was irrelevant to both the pre-operative width of the intervertebral foramen (wIVF) and the height of the intervertebral foramen (hIVF) in the ACDF+UPR group. However, pre-operative wIVF was associated with post-operative JOA and VAS scores in the ACDF alone group. Those with pre-operative wIVF <3 mm in the ACDF group had the least improvement in post-operative clinical symptoms due to the change in wIVF (P > 0.05). The ACDF group whose wIVF was over 3 mm showed similar clinical outcomes to the ACDF + UPR group, and wIVF significantly increased post-operatively (P < 0.05). The fusion rate and C2–C7 Cobb angles did not show significant differences between the two groups (P > 0.05). Discussion: Our current findings suggest that UPR should be considered when wIVF is <3 mm pre-operatively. However, there is no need to sacrifice the uncovertebral joint in ACDF when the pre-operative wIVF is over 3 mm. Level of Evidence: Level III.
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影响因子：
3
作者：
Ebraheim, NA;An, HS;Yeasting, RA
通讯作者：
Yeasting, RA
影响因子：
3
作者：
Tanaka, N;Fujimoto, Y;Yasuda, M
通讯作者：
Yasuda, M
影响因子：
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作者：
Pakzaban, Peyman
通讯作者：
Pakzaban, Peyman
影响因子：
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作者：
MARCELIS, S;SERAGINI, FC;RESNICK, D
通讯作者：
RESNICK, D
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作者：
Kotani, Y;McNulty, PS;McAfee, PC
通讯作者：
McAfee, PC