术前K线倾斜角预测后纵韧带骨化症单开门术后疗效的可行性分析

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Abstract

Objective To explore the feasibility of predicting the clinical effect of single open door laminoplasty in the treatment of ossification of the posterior longitudinal ligament by the preoperative K line tilt.Methods The data of 52 patients with ossification of the posterior longitudinal ligament (OPLL) with positive K line who were treated by posterior cervical singledoor laminoplasty from February 2019 to January 2022 were analyzed retrospectively.35 male and 17 female were included.The patients age from 47 to 76 years，with an average of (61.46±7.26)years.The score of the Japanese orthopedic association (JOA) before the operation and the JOA score at the oneyear followup after the operation were recorded.The parameters of sagittal plane before operation were measured on the neutral lateral radiograph of cervical spine，which including Kline tilt，C_2~7 Cobb angle，C_2~7sagittal vertical axis (C_2~7 SVA)，center gravity of head (CGH) ~ C₇ sagittal axial distance (CGH~C₇ SVA)，T₁ slope.According to the median JOA score 1 year after surgery，patients were divided into good improvement group and poor improvement group.The preoperative K-line tilt and other sagittal plane parameters were used as independent variables.One-way analysis of variance and Logistic regression were used to analyze the risk factors affecting the postoperative JOA improvement rate.Results The clinical symptoms of all patients were improved.The preoperative C_2~7 Cobb angle was (14.45±8.81)°，C_2~7 SVA was (15.31±4.57)mm，CGH~C₇ SVA was (16.37±5.23)mm，T₁slop was (26.43±5.65)°，K-line tilt was (12.77±1.49)° and preoperative JOA score of OPLL patients were (7.38±0.89) points.According to the improvement rate of JOA score at 1 year follow-up，the analysis of preoperative cervical sagittal parameters after grouping showed that the preoperative kline tilt，preoperative C_2~7SVA，preoperative CGH~C₇ SVA (P＜0.001，P＝0.013，P＝0.022) were closely related to the postoperative efficacy，and the preoperative K-line tilt was positively correlated with C_2~7SVA，CGH~C₇SVA(r＝0.411，r＝0.831，P＝0.004，P＝0.023).Logistic regression analysis showed that preoperative K-line tilt and preoperative CGH~C₇ SVA (OR=1.673，OR=1.522，P＝0.024，P＝0.033) were the risk factors affecting postoperative efficacy.Conclusion The postoperative efficacy of patients with OPLL is related to the preoperative K line tilt.The patients with large preoperative K line tilt have poor postoperative efficacy.The K line tilt can be used as a new clinical index to predict the postoperative efficacy of patients with OPLL before single-door surgery through the posterior cervical spine.

Key words： ossification of the posterior longitudinal ligament K-line tilt laminoplasty cervical sagittal parameters

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	Articles by authors
	Wang Chunzeng
	Zhang Jianwei
	Hu Menzi
	Han Meng
	Zhang Zhaochuan
	Li Jie
	Liu Guangwang

Cite this article:

Wang Chunzeng,Zhang Jianwei,Hu Menzi, et al. Feasibility Analysis of Predicting the Clinical Effect of Single Open Door Laminoplasty in the Treatment of Ossification of the Posterior Longitudinal Ligament By the Preoperative K Line Tilt[J]. sygkzz, 2023, 29(11): 961-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2023/V29/I11/961

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