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Influence of the Number of Cervical Fusion Levels on Cervical Spine Motion and Health-Related Quality of Life

机译：颈椎融合水平数量对颈椎运动和健康相关生活质量的影响

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Study Design.A retrospective study.Objective.To analyze the influence of the number of cervical fusion levels on total cervical motion and health-related quality of life (HRQoL) in patients with solid anterior cervical fusions (ACFs).Summary of Background Data.Few studies have analyzed the degree to which cervical range of motion (ROM) and HRQoL are affected by the number of cervical fusion segments.Methods.We analyzed a cohort of patients who underwent ACF for degenerative disc disease. To assess the clinical outcomes and HRQoL, preoperative, 1- and 2-year postoperative neck and arm pain, visual-analogue scale, neck disability index, and short form-36 were analyzed. Radiographically, C2-7 and C0-2 ROM, C2-7 sagittal vertical axis (SVA), and Kellgren grade of radiographic adjacent segment pathology (RASP) were evaluated.Results.A total of 105 patients (M:F=46:59, mean age of 51.4 yr) were enrolled. There were 36 patients who underwent single-level ACF (group 1), 41 patients who had a double level ACF (group 2), and 28 patients who underwent ACF involving 3 or more levels (group 3). There was no decrease in C2-7 motion in group 1, a mean 7-degree decrease in group 2, a mean 18-degree decrease in those who underwent a 3-level ACF, and a mean 22-degree decrease after 4-level ACF. The grade of RASP was not influenced by the number of fusion levels. All HRQoL parameters showed no significant correlation between number of fusion levels, cervical ROM, and SVA.Conclusion.Single-level ACF showed no decrease in total cervical motion; multilevel ACF decreased cervical motion by a mean of 7.8 degrees per segment of fusion. Progression of RASP showed no correlation with the number of fusion levels. HRQoLs were not influenced by the number of fusion levels, cervical ROM, or SVA after solid ACF.Level of Evidence: 3
机译：研究设计是一项回顾性研究，目的是分析实体前路颈椎融合器（ACF）患者颈椎融合器数量对总颈椎运动和健康相关生活质量（HRQoL）的影响。背景数据摘要。很少有研究分析颈椎融合节段的数量对颈椎活动范围（ROM）和HRQoL的影响程度。方法：我们分析了一群接受ACF变性椎间盘疾病的患者。为了评估临床结局和HRQoL，分析了术前，术后1年和2年后的颈部和手臂疼痛，视觉模拟量表，颈部残疾指数和36型简表。影像学评估了C2-7和C0-2 ROM，C2-7矢状纵轴（SVA）和Kellgren分级的影像学邻近节段病变（RASP）。结果，共105例患者（M：F = 46：59） ，平均年龄为51.4岁）。有36例接受单水平ACF（第1组），41例具有双水平ACF（第2组）和28例接受3个或更多水平的ACF（第3组）。第1组中C2-7运动没有减少，第2组中平均降低了7度，接受3级ACF的患者平均降低了18度，而在4级后的平均降低了22度ACF。 RASP的等级不受融合水平数量的影响。所有HRQoL参数均显示融合水平数目，子宫颈ROM和SVA之间无显着相关性。结论。多级ACF每融合段平均可降低子宫颈运动7.8度。 RASP的进展表明与融合水平的数量无关。实心ACF后HRQoL不受融合水平，子宫颈ROM或SVA数量的影响。证据水平：3

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