The Relationship Between Preoperative Cervical Sagittal Balance and Clinical Outcome of Patients With Hirayama Disease Treated With Anterior Cervical Discectomy and Fusion

Xiao Lu; Guang-Yu Xu; Cong Nie; Yu Xuan Zhang; Jian Song; Jianyuan Jiang

doi:10.14245/ns.2142564.282

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자료유형: 학술저널

저자정보: Xiao Lu (Department of Orthopaedics Huashan Hospital Fudan University) Guang-Yu Xu (Department of Orthopaedics Huashan Hospital Fudan University) Cong Nie (Department of Orthopaedics Huashan Hospital Fudan University) Yu Xuan Zhang (Department of Orthopaedics Huashan Hospital Fudan University) Jian Song (Department of Orthopaedics Huashan Hospital Fudan University) Jianyuan Jiang (Department of Orthopedics Huashan Hospital Fudan University)

저널정보: 대한척추신경외과학회 Neurospine Neurospine 제18권 제3호

발행연도: 2021.9

수록면: 618 - 627 (10page)

DOI: 10.14245/ns.2142564.282

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Objective: Anterior cervical discectomy and fusion (ACDF) is a common surgical method used to treat patients with Hirayama disease. And sagittal balance indexes have been revealed to be predictors of clinical outcomes in patients with cervical diseases, but their relationships with ACDF-treated Hirayama disease outcomes remain unknown. The purpose of this study is to evaluate the relationship of preoperative cervical sagittal balance indexes and clinical outcomes in ACDF-treated Hirayama disease patients. Methods: Eighty patients with Hirayama disease treated by ACDF were reviewed retrospectively. Six cervical sagittal balance parameters were collected including Cobb angle, T1 slope, C1?7 sagittal vertical axis (SVA), C2?7 SVA, center of gravity of the head (CGH)-C7 SVA, range of motion. The recovery outcomes of the patients were divided into 2 groups by Odom score and the differences in recovery between the 2 groups were confirmed by electromyography. The correlation between imaging parameters and postoperative outcome was evaluated with logistic regression. The receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were used to evaluate the significant result of logistic regression and the optimal diagnostic value. Results: Only 2 parameters, Cobb angle and CGH-C7 SVA, showed statistical correlation with the postoperative outcome assessment by logistic regression. AUC of Cobb angle and CGH-C7 SVA were 0.559 and 0.702 respectively. The optimal predictive threshold was 1.50° and 5.40 mm, respectively. Conclusion: A larger Cobb angle and smaller CGH-C7 SVA seemed to correlate with a better postoperative outcome. These 2 factors could be used to predict the outcome of surgical treatment of Hirayama disease preoperatively.

#Cobb angle #CGH-C7 SVA #Sagittal balance #Hirayama disease #Clinical outcome

참고문헌 (34)

참고문헌 신청

Hirayama K / 1963 / Juvenile muscular atrophy of unilateral upper extremity / Neurology 13:373~380

Hirayama K / 2008 / Juvenile muscular atrophy of unilateral upper extremity (Hirayama disease)--half-century progress and establishment since its discovery / Brain Nerve 60:17~29

Kieser DC / 2018 / Hirayama disease / Eur Spine J 27:1201~1206

Waljee JF / 2011 / Development of a brief, 12-item version of the Michigan Hand Questionnaire / Plast Reconstr Surg 128:208~220

Kameyama T / 1997 / Delayed exacerbation of cervical myelopathy in a case of juvenile muscular atrophy of unilateral distal upper extremity / Rinsho Shinkeigaku 37:60~63

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