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Dai L, Du K, Guo P, Gong H, Wang W, Hou X, Qin C, Zhang C. Comparison of Laminectomy with Fusion and Laminoplasty Treating Multilevel Cervical Spondylotic Myelopathy: A Single-Center Retrospective Study. World Neurosurg 2024; 186:e487-e494. [PMID: 38583558 DOI: 10.1016/j.wneu.2024.03.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE Comparing laminectomy with fusion (LF) and laminoplasty (LP) for treating multilevel cervical spondylotic myelopathy (MCSM) and comparative analysis of neck pain and sagittal cervical parameters. METHODS This single-center study retrospectively analyzed MCSM patients treated with LF or LP in our department between June 2018 and January 2023, with at least a 12-month follow-up. T-tests were used to identify operation time, hemoglobin, hospital stay, modified Japanese Orthopaedic Association (mJOA) score, C2-C7 Cobb angle, C2-C7 sagittal vertical axis, T1 slope, cervical range of motion (cROM), and C4/5 anterior and posterior spinal canal diameter (A-P diameter) and area. Nonparametric tests were used to identify visual analog scale (VAS) score (assessing neck pain). Pearson correlation analyses were used to identify the neck pain. RESULTS Of all 67 patients (LF: 24, LP: 43), both groups' mJOA scores significantly improved (P < 0.001). The VAS scores had both significantly decreased, with the LF group exhibiting a more marked reduction (LF: P < 0.001, LP: P = 0.037). Both groups' C4/5 A-P diameters and areas increased significantly (P < 0.001). The cROM had both significantly decreased, with the LF group exhibiting a greater reduction. At the last follow-up, the LF group's T1 slope and C2-C7 Cobb angle considerably increased, and pain VAS scores substantially correlated with the C2-C7 Cobb angle (R = -0.451, P < 0.001). CONCLUSIONS LF and LP were efficacious for MCSM. LF relieved neck pain better but caused greater reduction in cervical mobility. Cervical lordosis improvement was significantly correlated with neck pain alleviation.
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Affiliation(s)
- Liping Dai
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Kaili Du
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Peiyu Guo
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Hongda Gong
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Weizhou Wang
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xiaodong Hou
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Chao Qin
- Department of orthopaedics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Chunqiang Zhang
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
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Huang L, Chen W, Xu H, Qin H, Jiang H. Odontoid incidence: a constant cervical anatomical feature evident in standing plain radiographs and supine magnetic resonance images. J Orthop Surg Res 2024; 19:63. [PMID: 38218851 PMCID: PMC10787454 DOI: 10.1186/s13018-024-04542-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/08/2024] [Indexed: 01/15/2024] Open
Abstract
OBJECTIVE To assess whether there is a difference between measurements of odontoid incidence (OI) and other cervical sagittal parameters by X-ray radiography and those by supine magnetic resonance imaging (MRI). METHODS Standing X-ray and supine MRI images of 42 healthy subjects were retrospectively analyzed. Surgimap software was employed to measure cervical sagittal parameters including OI, odontoid tilt (OT), C2 slope (C2S), C0-2 angle, C2-7 angle, T1 slope (T1S) and T1S-cervical lordosis (CL). Paired samples t-test was applied to determine the difference between parameters measured by standing X-ray and those by supine MRI. In addition, the statistical correlation between the parameters were compared. The prediction of CL was performed and validated using the formula CL = 0.36 × OI - 0.67 × OT - 0.69 × T1S. RESULTS Significant correlations and differences were found between cervical sagittal parameters determined by X-ray and those by MRI. OI was verified to be a constant anatomic parameter and the formula CL = 0.36 × OI - 0.67 × OT - 0.69 × T1S can be used to predict CL in cervical sagittal parameters. CONCLUSIONS OI is verified as a constant anatomic parameter, demonstrating the necessity of a combined assessment of cervical sagittal balance by using standing X-ray and supine MRI. The formula CL = 0.36 × OI - 0.67 × OT - 0.69 × T1S can be applied to predict CL in cervical sagittal parameters.
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Affiliation(s)
- Longao Huang
- Department of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Weiyou Chen
- Department of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Hongyuan Xu
- Department of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Hongyu Qin
- Department of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Hua Jiang
- Department of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, China.
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Dai L, Qin C, Guo P, Gong H, Wang W, Hou X, Du K, Zhang C. Comparison of anterior cervical diskectomy with fusion (ACDF) and laminoplasty treating multilevel cervical spondylotic myelopathy with developmental canal stenosis: a retrospective study. J Orthop Surg Res 2024; 19:29. [PMID: 38172985 PMCID: PMC10763361 DOI: 10.1186/s13018-023-04510-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/24/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE To evaluate clinical effectiveness and radiologic results of anterior cervical diskectomy with fusion (ACDF) comparing with laminoplasty (LP) in treating multilevel cervical spondylotic myelopathy (MCSM) with developmental canal stenosis (DCS). METHODS This was a retrospective analysis of 41 patients who had MCSM with DCS treated with ACDF or LP from December 2018 to April 2023. Patients were split into ACDF and LP groups for comparison, and patients were further separated into subgroups based on whether or not a reserving canal space was present. The operation time, hemoglobin, hospital stay, modified Japanese Orthopaedic Association (mJOA) score, and visual analog scale (VAS) score were used to assess clinical efficacy. The C2-C7 Cobb angle, C2-C7 sagittal vertical axis, T1 slope, and cervical range of motion were applied to evaluate imaging changes. RESULTS Of the 41 patients, 19 received ACDF, and 22 received LP. At the final follow-up, both groups' mJOA scores significantly improved, and the intercomparison showed no differences; the VAS score was much lower in the ACDF group but remained unchanged in the LP group. At the final follow-up, the C2-C7 Cobb angle and T1 slope had significantly increased in the ACDF group, while the LP group showed no change; the cervical range of motion had significantly decreased in both groups, with the ACDF group exhibiting a more marked reduction. Within the ACDF subgroup, there was no postoperative symptom improvement for those with reserving space, whereas there was postoperative symptom resolution for those with non-reserving space; however, postoperative symptom in the LP subgroup was resolved. CONCLUSIONS Both ACDF and LP were efficacious for MCSM patients with DCS. While ACDF could improve cervical lordosis and alleviate neck pain more effectively, it can also result in cervical sagittal imbalance and decreased mobility. Furthermore, the recovery from LP was superior to that from ACDF for patients with reserving space. In contrast, the recovery from both decompression techniques was comparable for individuals in non-reserving space.
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Affiliation(s)
- Liping Dai
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, NO.295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Chao Qin
- Department of orthopaedics, Fujian Medical University Union Hospital, Antai Street, Fuzhou, 350001, Fujian, China
| | - Peiyu Guo
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, NO.295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Hongda Gong
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, NO.295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Weizhou Wang
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, NO.295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Xiaodong Hou
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, NO.295 Xichang Road, Kunming, 650032, Yunnan, China
| | - Kaili Du
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, NO.295 Xichang Road, Kunming, 650032, Yunnan, China.
| | - Chunqiang Zhang
- Department of orthopaedics, First Affiliated Hospital of Kunming Medical University, NO.295 Xichang Road, Kunming, 650032, Yunnan, China.
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Lee SH, Kim TH, Kim SW, Rim HT, Lee HS, Kim JH, Chang IB, Song JH, Hong YK, Oh JK. The Sagittal Balance of Cervical Spine : Comprehensive Review of Recent Update. J Korean Neurosurg Soc 2023; 66:611-617. [PMID: 37583244 PMCID: PMC10641420 DOI: 10.3340/jkns.2023.0146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/04/2023] [Accepted: 08/12/2023] [Indexed: 08/17/2023] Open
Abstract
The cervical spine plays a critical role in supporting the skull, maintaining horizontal gaze, and facilitating walking. Its unique characteristics, including the widest range of motion among spinal segments, have led to extensive research on cervical sagittal alignment. Various parameters have been proposed to evaluate cervical alignment, with studies investigating their clinical significance, correlation with symptoms, and implications for surgical interventions. Recent findings suggest that cervical sagittal alignment not only impacts the cervical spine but also influences global spine-pelvic alignment through compensatory mechanisms. This comprehensive review examines classical and new parameters of cervical sagittal alignment and considers the dynamic and muscular factors associated with it.
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Affiliation(s)
- Sang Hoon Lee
- Departments of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Tae Hwan Kim
- Departments of Orthopedics, Hallym University Sacred Heart Hospital, Anyang, Korea
- Spine Center, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Seok Woo Kim
- Departments of Orthopedics, Hallym University Sacred Heart Hospital, Anyang, Korea
- Spine Center, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hyun Take Rim
- Departments of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Heui Seung Lee
- Departments of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Ji Hee Kim
- Departments of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - In Bok Chang
- Departments of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Joon Ho Song
- Departments of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Yong Kil Hong
- Departments of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jae Keun Oh
- Departments of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea
- Spine Center, Hallym University Sacred Heart Hospital, Anyang, Korea
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Liu C, Li Y, Li X, Shi B, Lu S. Factors related to T1 slope: spinopelvic balance and thoracic compensation. BMC Surg 2023; 23:145. [PMID: 37248467 DOI: 10.1186/s12893-023-02053-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/23/2023] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVE To identify factors associated with T1 slope (T1S). METHODS A total of 215 patients over 18 years old who underwent whole-spine X-rays to evaluate lower back pain were enrolled in this study. T1S, pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI), thoracic kyphosis (TK), lumbar lordosis (LL), cervical lordosis (CL), thoracolumbar kyphosis (TLK), and sagittal vertical axis (SVA) were measured. Patients were divided into balance, compensatory balance, thoracic compensation, and thoracic decompensation groups. RESULTS TK (p < 0.001), SVA (p < 0.001), and CL (p = 0.020) were significantly related to high T1S. The balance group had the smallest PT, largest SS and largest LL of the four groups (p < 0.001). The thoracic compensation group had the smallest TK of all groups (p < 0.001). There was no significant difference in T1S between the balance and thoracic compensation groups (p = 0.099). The thoracic decompensation group had a larger T1S than the balance group (p = 0.023). CONCLUSIONS Caudal spine segments had a sequential effect on cranial spine segments. T1S reflected the compensation ability of the spine. The absence of balance tended to increase the T1S. Pelvic posterior rotation and thoracic compensation were two crucial factors protecting against increased T1S in patients with ASD.
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Affiliation(s)
- Chengxin Liu
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Yongjin Li
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Xiangyu Li
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Bin Shi
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Shibao Lu
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China.
- National Clinical Research Center for Geriatric Diseases, Beijing, China.
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Li XY, Wang Y, Zhu WG, Liu CX, Kong C, Lu SB. Cervical sagittal alignment changes following anterior cervical discectomy and fusion, laminectomy with fusion, and laminoplasty for multisegmental cervical spondylotic myelopathy. J Orthop Surg Res 2023; 18:190. [PMID: 36906572 PMCID: PMC10007737 DOI: 10.1186/s13018-023-03640-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/23/2023] [Indexed: 03/13/2023] Open
Abstract
OBJECTIVE Cervical sagittal alignment changes (CSACs) influence outcomes and health-related quality-of-life. Anterior cervical discectomy and fusion (ACDF), laminectomy with fusion (LCF), and laminoplasty (LP) are common treatments for multisegmental cervical spondylotic myelopathy; however, these approaches need to be compared. METHODS Our study included 167 patients who underwent ACDF, LCF, or LP. Patients were divided into four groups according to C2-C7 Cobb angle (CL): kyphosis (CL < 0°), straight (0° ≤ CL < 10°), lordosis (10° ≤ CL < 20°), and extreme lordosis (20° ≤ CL) groups. CSACs consist of two parts. CSAC from the preoperative period to the postoperative period is surgical correction change (SCC). CSAC from the postoperative period to the final follow-up period is postoperative lordosis preserving (PLP). Outcomes were evaluated using the Japanese Orthopaedic Association score and the neck disability index. RESULTS ACDF, LCF, and LP had equivalent outcomes. ACDF had greater SCC than LCF and LP. During follow-up, lordosis decreased in the ACDF and LCF groups but increased in the LP group. For straight alignment, ACDF had greater CSAC and greater SCC than the LCF and LP groups but similar PLP. For lordosis alignment, ACDF and LP had positive PLP, and LCF had negative PLP. For extreme lordosis, ACDF, LP, and LCF had negative PLP; however, cervical lordosis in the LP group was relatively stable during follow-up. CONCLUSIONS ACDF, LCF, and LP have different CSAC, SCC, and PLP according to a four-type cervical sagittal alignment classification. Preoperative cervical alignment is an important consideration in deciding the type of surgical treatment in CSM.
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Affiliation(s)
- Xiang-Yu Li
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, China.,National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Yu Wang
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, China.,National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Wei-Guo Zhu
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, China.,National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Cheng-Xin Liu
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, China.,National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Chao Kong
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, China.,National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Shi-Bao Lu
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, China. .,National Clinical Research Center for Geriatric Diseases, Beijing, China.
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Wu J, Guo R, Yang C, Yan H, Wang Z, Chen Z, Peng X, Zhang D, Jiang X, Zhao Q, Li B, Hu X, Gao L. The Difference of Sagittal Correction of Adult Subaxial Cervical Spine Surgery According to Age: A Retrospective Study. Orthop Surg 2022; 14:1790-1798. [PMID: 35819084 PMCID: PMC9363747 DOI: 10.1111/os.13385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 06/05/2022] [Accepted: 06/07/2022] [Indexed: 11/06/2022] Open
Abstract
Objective At present, the true sagittal alignment of the cervical spine is uncertain, resulting in no standard reference for subaxial cervical surgery. So, we aimed to explore the age difference of normal cervical sagittal alignment and to further investigate the mid‐and long‐term changes of sagittal alignment after subaxial cervical spine surgery. Materials and Methods This was a retrospective study and 1223 asymptomatic volunteers and 79 patients undergoing subaxial cervical spine surgery were retrospectively reviewed in total. Asymptomatic volunteers and patients were divided into six subgroups: 20–29, 30–39, 40–49, 50–59, 60–69 and ≥70 groups. The age difference and trend with age of cervical sagittal parameters of asymptomatic volunteers were assessed by cervical lateral radiography and analyzed by ANOVA test, and the regression equation of C2‐7 Cobb was established via multiple linear regression. Based on the C2‐7 Cobb regression equations of different ages, the theoretical value, deviation value, loss value of the C2‐7 Cobb, and JOA recovery rate of patients were calculated, and the correlation among the loss value, deviation value of the C2‐7 Cobb, and JOA recovery rate of the 79 patients was evaluated by Pearson correlation analysis. Results For the asymptomatic volunteers, the C0‐2 Cobb decreased gradually with increasing age. The C2‐7 Cobb, C2‐7 SVA, T1S, NT, and TIA increased gradually with increasing age. The CBVA fluctuated with increasing age. T1S demonstrated a moderate correlation with C2‐7 Cobb (r = 0.60, p < 0.01); C0‐2 Cobb, C2‐7 SVA, CBVA, and TIA demonstrated a fair correlation with C2‐7 Cobb (r = −0.30, −0.33, 0.41, 0.40, p < 0.01); age demonstrated a poor correlation with C2‐7 Cobb (r = 0.19, p < 0.01). The regression equations of C2‐7 Cobb were established using C0‐2 Cobb, C2‐7 SVA, CBVA, and T1S. For the patients with subaxial cervical spine surgery, the loss of C2‐7 Cobb was moderately correlated with the deviation of C2‐7 Cobb (r = 0.33, p < 0.01). Conclusion The age difference of cervical sagittal alignment was obvious, and the C2‐7 Cobb increased with age especially. The closer the postoperative C2‐7 Cobb was to the theoretical value of corresponding age, the smaller the loss of correction angle was, and the better the mid‐ and long‐term outcomes. The personalized sagittal reconstruction should be performed according to age difference for subaxial cervical spine surgery.
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Affiliation(s)
- Jionglin Wu
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Rui Guo
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Canchun Yang
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Haolin Yan
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zheyu Wang
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhipeng Chen
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiaoshuai Peng
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Di Zhang
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xu Jiang
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Qiancheng Zhao
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Bo Li
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xumin Hu
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Liangbin Gao
- Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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Wei Z, Zhang Y, Yang S, Cai C, Ye J, Qiu H, Hu X, Qu Y, Wen X, Chu T. Retrospective Analysis of Sagittal Balance Parameters and Clinical Efficacy After Short-Segment Anterior Cervical Spine Surgery with Different Fusion Devices. Int J Gen Med 2022; 15:3237-3246. [PMID: 35345776 PMCID: PMC8957297 DOI: 10.2147/ijgm.s340877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 03/11/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To compare the cervical sagittal balance parameters and clinical efficacy of three fusion devices after short-segment anterior cervical discectomy and fusion. Patients and Methods Retrospectively analyzed 516 patients with cervical spondylosis who underwent surgery at our hospital from May 2013 to May 2019. All patients had complete data and were divided into three groups according to the selected fusion cage. Neck and upper limb pain were assessed by the visual analog scale (VAS) score. Neurological function was evaluated by the modified Japanese Orthopedics Society (mJOA) score. Also, the curvature of the cervical spine and the occurrence of dysphagia were observed. Results There were no significant differences in the general information, thoracic inlet angle, T1 slope, or surgical data among the groups (p>0.05). There were significant differences in the scores between pre- and postoperatively in the different groups (p<0.05). There were no significant differences in the C2-C7 Cobb angle or C2-C7 sagittal vertebral axis before the operation among the groups (p>0.05). There was a significant difference in the correction and loss of correction among the groups postoperatively and on follow-up (p>0.05). Dysphagia was less likely in the Zero-P VA fusion group than in the other two groups. Conclusion Different fusion instruments can relieve the symptoms. In the Prodisc-C Vivo group, no significant improvement in cervical sagittal balance was achieved. A good effect on improving sagittal balance was observed in both the Zero-P VA fusion and Skyline anterior cervical titanium plate groups, but a better effect on preventing dysphagia was observed in the Zero-PVA fusion group.
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Affiliation(s)
- Zihan Wei
- Department of Orthopedics, Xinqiao Hospital of Chongqing, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, People's Republic of China
| | - Ying Zhang
- Department of Orthopedics, Xinqiao Hospital of Chongqing, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, People's Republic of China
| | - Sizhen Yang
- Department of Orthopedics, Xinqiao Hospital of Chongqing, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, People's Republic of China
| | - Chenhui Cai
- Department of Orthopedics, Xinqiao Hospital of Chongqing, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, People's Republic of China
| | - Jiawen Ye
- Department of Orthopedics, Xinqiao Hospital of Chongqing, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, People's Republic of China
| | - Hao Qiu
- Department of Orthopedics, Xinqiao Hospital of Chongqing, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, People's Republic of China
| | - Xu Hu
- Department of Orthopedics, Xinqiao Hospital of Chongqing, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, People's Republic of China
| | - Yiyun Qu
- Department of Orthopedics, Xinqiao Hospital of Chongqing, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, People's Republic of China
| | - Xuan Wen
- Department of Orthopedics, Xinqiao Hospital of Chongqing, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, People's Republic of China
| | - Tongwei Chu
- Department of Orthopedics, Xinqiao Hospital of Chongqing, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, People's Republic of China
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Chu Y, Zhang Y, Wang S, Dai H. Resilience mediates the influence of hope, optimism, social support, and stress on anxiety severity among Chinese patients with cervical spondylosis. Front Psychiatry 2022; 13:997541. [PMID: 36213904 PMCID: PMC9539388 DOI: 10.3389/fpsyt.2022.997541] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Cervical spondylosis (CS) is a potential stressor threatening mental health among affected individuals. This study was to analyze resilience level and associated factors among cervical spondylosis (CS) patients, and to explore the underlying mechanism of anxiety based on resilience-focused psychological variables. METHODS Resilience Scale-14 (RS-14), Zung Self-Rating Anxiety Scale (SAS), Herth Hope Index (HHI), Revised Life Orientation Test (LOT-R), Multidimensional Scale of Perceived Social Support (MSPSS), Perceived Stress Scale-10 (PSS-10) were used in this cross-sectional investigation among 250 CS patients. RESULTS The score of resilience was 65.58 ± 16.14. Hierarchical linear regression analysis revealed that hope, optimism, perceived social support, perceived stress, and whether having comorbid chronic diseases were the independent associates of resilience among CS patients, which explained 63.9% of the total variance. The structural equation model showed that hope, optimism, perceived social support and perceived stress affected anxiety via resilience, and hope and optimism also had direct effects on anxiety. CONCLUSION Chinese patients with CS had moderate level of mental resilience, which was independently related to hope, optimism, perceived social support, perceived stress, and whether having comorbid chronic diseases. Resilience played a mediating role between various psychological variables and anxiety. Improving the level of resilience, hope, optimism and perceived social support and reducing the level of perceived stress are important strategies to reduce anxiety level. Relevant healthcare professionals should put more focus on the mental problems of Chinese CS patients and help maintain good psychological status by improving their resilience and associated psychological variables thereof.
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Affiliation(s)
- Yuying Chu
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Yuqiang Zhang
- The First Affiliated Hospital, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Suyan Wang
- Centre for Mental Health Guidance, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Hongliang Dai
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
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