|关键词||颈椎人工间盘置换术 椎旁骨化 异位骨化 分型 邻近节段|
|其他题名||The comparison of paravertebral ossification progression among operative, adjacent and non-adjacent levels after artificial cervical disc replacement: a 7-year follow-up|
Introduction: Paravertebral ossification (PO) is a vital phenomenon following artificial cervical disc replacement (CADR). Controversy about the cause and seriousness of PO always exists. Because PO could occur in normal cervical spine, and the former PO could grow gradually with age increasing. So if the influence of CADR on the development of PO was going to be assessed, it’s reasonable to compare the operative and adjacent segments with normal segments. Besides, different segments may have different PO growth speed, so each cervical spine segments need to be assessed separately. This study focused on the difference of PO prevalence and progression in operative, adjacent and non-adjacent levels through a long-term follow-up, and discussed the influence of CADR on PO development.
Methods: Radiograph data for all patients performed single-level CADR using Bryan disc from a single center were used. Preoperative and 7-year follow-up CT images were collected. Two independent blinded surgeons graded PO based on a revised CT PO grading system from C2/3 to C7/T1 segments in each patient. Each segment was divided into operative, adjacent or non-adjacent level groups. Non-adjacent level group was considered as the normal contrast group. The progression of PO in each group was compared using Chi-square test.
Results: A total of 45 patients were included. The average follow-up time was 79.6 months (range 57-108 months). The prevalence of high-level PO in area L and R of operative levels was higher than the normal contrast group in same segments. And the progression of PO in tPOse areas was significantly severer (p<0.05) than non-adjacent levels in comparison of preoperative with the final follow-up. AltPOugh the prevalence of high-level PO in area A and P of operative levels and all areas of adjacent levels was also higher than the normal contrast group in same segments, there was no significant difference (p>0.05) in PO progression.
Conclusion: On the results of the 7-year follow-up, CADR had no significant influence on the progression of PO development in adjacent levels. The progression of PO in CADR operative level was concentrated on area L and R, which were basically the areas of Luschka joints.
|曾成. 颈椎人工间盘置换术后手术节段、邻近节段与非邻近节段的椎旁骨化长期进展对比[D]. 北京大学第四临床医学院. 北京大学,2016.|