【摘要】 目的:分析寰枢椎脱位患者上颈椎术后颈椎矢状位参数变化及影响因素。方法:对2011年3月至2022年7月行上颈椎手术的15例寰枢椎脱位患者进行回顾性分析,统计所有患者的基本信息及术前与末次随访的矢状位参数,包括枕颈角(C0-C2 Cobb角)、下颈椎曲度(C2-C7 Cobb角)、T1倾斜角、颈椎矢状面轴向垂直距离(C2-C7 SVA),并进行统计学分析。结果:末次随访时患者的C2-C7 Cobb角为15.18°±12.41°,小于术前的24.30°±15.57°;末次随访时患者的T1倾斜角为28.09°±15.20°,大于术前的24.14°±15.59°,差异均有统计学意义(P均<0.05)。末次随访时患者C0-C2 Cobb角和C2-C7 SVA增大,但与术前相比差异无统计学意义(P均>0.05)。ΔC2-C7 Cobb角与术前C2-C7 Cobb角的大小有关,差异有统计学意义(P<0.05)。术前C2-C7 Cobb角>20°的患者术后均出现不同程度的下颈椎曲度减小。结论:接受上颈椎手术的寰枢椎脱位患者术后可能出现下颈椎曲度减小,术后下颈椎曲度的丢失与术前C2-C7 Cobb角的角度有关,术前C2-C7 Cobb角>20°可能增加下颈椎曲度减小的风险。更多还原

【Abstract】 Objective: To analyze the changes in cervical sagittal parameters and the Influencing factors in patients with atlantoaxial dislocation after upper cervical spine surgery. Methods: A retrospective analysis of 15 patients with atlantoaxial dislocation who underwent upper cervical spine surgery from March 2011 to July 2022 was conducted. All patients’ basic information and sagittal parameters including occipitocervical angle(C0-C2 Cobb angle), lower cervical curvature(C2-C7 Cobb angle), T1 slope and C2-C7sagittal vertical axis(C2-C7 SVA) before surgery and at the last follow-up were counted and statistically analyzed. Results: The C2-C7Cobb angle at the last follow-up was significantly lower than the preoperative one(15.18°±12.41° vs. 24.30°±15.57°, P<0.05), and the T1 slope at the last follow-up was significantly higher than the preoperative one(28.09°±15.20° vs. 24.14°±15.59°, P<0.05). Compared with preoperative ones, the C0-C2 Cobb angle and C2-C7 SVA were increased, but no statistically significant difference was found(both P>0.05). ΔC2-C7 Cobb angle was significantly related to the preoperative C2-C7 Cobb angle(P<0.05). The varying degrees of lower cervical curvature reduction ocurred after surgery in patients with a preoperative C2-C7 Cobb angle >20°. Conclusions: Patients with atlantoaxial dislocation who underwent upper cervical surgery may have reduced lower cervical curvature postoperatively. Loss of lower cervical curvature postoperatively is related to the angle of preoperative C2-C7 Cobb angle, and a preoperative C2-C7 Cobb angle >20° may increase the risk of reduced lower cervical curvature.更多还原