颈椎前路椎间盘切除减压植骨融合术后轴性痛的危险因素

Risk Factors for Axial Pain after Anterior Cervical Discectomy and Fusion

摘要: 轴性痛作为一种严重影响病人生活质量的术后并发症，其危险因素目前尚存在很多争论。鉴于ACDF术后轴性痛的不确定性和争议，我们进行了此项回顾性研究以明确单节段颈椎病患者ACDF手术后发生轴性痛的潜在危险因素；为预防ACDF相关的术后轴性痛提供证据，并提高接受ACDF治疗的颈椎病患者的临床结局。我们回顾了2021年1月至2022年1月，因患有单节段颈椎病而接受了的ACDF的患者。根据术后颈部视觉模拟评分测量的术后轴性痛的严重程度。将患者分为中至重度轴性疼痛及无或轻度轴性疼痛两组。统计术前和术后包括年龄、性别、症状持续时间、体重指数(BMI)、日本骨科协会评估治疗分数(JOA)以及放射学参数在内的临床资料，并对两组之间的数据进行比较。夏皮罗–威尔克检验法用于检验连续变量的正态性。若数据未通过正态性检验，用皮尔森卡方检验和曼–惠特尼秩和检验分别确定分类变量和连续变量分组之间的统计显著差异；对可能有意义的变量再行多元Logistic回归分析，筛选出轴性痛的独立危险因素。

Abstract: Axial pain is a kind of postoperative complication which seriously affects patients’ quality of life. Due to the uncertainty and controversy on postoperative axial pain after ACDF, we aimed to: identi-fy the potential risk factors of post-operative axial pain after ACDF and provide evidence in pre-venting ACDF-related post-operative axial pain, and increase the clinical outcome of ACDF-treated patients. Patients who suffered from single‐level CSM and who received ACDF between 2021 January to 2022 January were reviewed. Patients were divided into two groups according to the severity of postoperative axial pain as measured by postoperative neck visual analogue scale (nVAS). Clinical parameters including age, sex, smoking history, symptom duration, body mass index (BMI), the Japanese Orthopaedic Association (JOA) scores, as well as radiological parameters were obtained pre‐ and post‐operatively, and the data were compared between two groups. Pearson’s chi‐ square tests and Mann-Whitney U tests were implemented to identify statistically significant differences between subgroups for categorical and continuous data, respectively; otherwise, the data were tested with Student’s t‐test. Risk factors were identified using logistic regression.