医学
分散注意力
颈椎前路椎间盘切除融合术
优势比
回顾性队列研究
可视模拟标度
逻辑回归
外科
放射性武器
脊柱融合术
风险因素
后凸
内科学
颈椎
射线照相术
神经科学
生物
作者
Wuyi Xiong,Jiaming Zhou,Chao Sun,Zhao Chen,Xing Guo,Xiaoyang Huo,Shiwei Liu,Jingchao Li,Yuan Xue
出处
期刊:Spine
[Ovid Technologies (Wolters Kluwer)]
日期:2020-01-15
卷期号:45 (2): 96-102
被引量:21
标识
DOI:10.1097/brs.0000000000003209
摘要
In Brief Study Design. Retrospective analysis. Objective. This study aimed to compare the clinical and radiological outcomes of different degrees of distraction in anterior cervical discectomy and fusion (ACDF) and evaluate the risk factors for adjacent segment degeneration (ASD). Summary of Background Data. ASD is a common complication following ACDF. Inadequate distraction of the intervertebral space during surgery is associated with ASD; however, there is still an ongoing debate regarding what degree of distraction is appropriate. Methods. This retrospective study enrolled 130 patients who underwent single-level ACDF for cervical degenerative disc disease and were followed up at least 2 years. The patients were divided into the following three groups according to the degree of distraction (≤0.5, 0.5–1, ≥1): insufficient distraction group (ID group), appropriate distraction group (AD group), and excessive distraction group (ED group). The clinical outcomes and radiological parameters were evaluated before and after operation and at the last follow-up. Risk factors for ASD were identified through logistic regression analysis. Results. A significant difference was found in the Visual Analog Scale values between the AD group and ED group at the final follow-up. Moreover, the highest upper segmental disc height (DH), highest lower segmental DH, and lowest incidence of ASD were found in the AD group among the three groups at last follow up. Logistic regression analysis revealed that segmental kyphosis (odds ratio = 2.821, P = 0.020) was a risk factor for the occurrence of ASD and 0.5- to 1-fold distraction (odds ratio = 0.350, P = 0.025) was a protective factor. Conclusion. Good clinical and radiological outcomes were achieved in ACDF with 0.5- to 1-fold distraction. Segmental kyphosis is a risk factor for ASD in ACDF, whereas 0.5- to 1-fold distraction is a protective factor of ASD. Level of Evidence: 4 This study enrolled 130 patients who underwent single-level anterior cervical discectomy and fusion. According to the degree of distraction (≤0.5, 0.5–1, ≥1), the patients were divided into three groups. Logistic regression analysis revealed that 0.5- to 1-fold distraction was a protective factor for the occurrence of adjacent segment degeneration.
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