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已发表论文

颈椎后凸畸形患者在接受颈椎手术治疗脊髓损伤后临床疗效差的发生率和危险因素

 

Authors Zhang Y, Li J, Li Y, Shen Y

Received 26 August 2017

Accepted for publication 14 November 2017

Published 8 December 2017 Volume 2017:13 Pages 1563—1568

DOI https://doi.org/10.2147/TCRM.S150096

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Hoa Le

Peer reviewer comments 2

Editor who approved publication: Professor Deyun Wang

Objective: This retrospective study investigated the incidence and risk factors of poor clinical outcomes after cervical surgery for cervical spinal cord injury in a large population of patients with global or segmental cervical kyphosis.
Methods: The clinical and radiological evaluation results of 269 patients with cervical kyphosis who underwent either anterior or posterior surgery between 2008 and 2013 were collected, preoperatively and at each follow-up after surgery.
Results: All patients were followed for an average of 2.5 years. Outcomes were classified as good or poor (n=156 and 113 patients, respectively), based on the Japanese Orthopedic Association (JOA) recovery ratios. The rates of patients with good or poor outcomes were statistically comparable with regard to gender ratio, type of injury, history of diabetes or cardiovascular disease, interval between injury and surgery, and follow-up time. The multivariate logistic regression analysis indicated that the following were independent predictors of poor improvement: patient age (=0.016, odds ratio [OR] =1.0261); preoperative JOA scores (=0.003, OR =0.1932); and cervical instability (P =0.004, OR =2.1562).
Conclusion: This study showed that advanced age, low preoperative JOA score, and cervical instability are closely associated with a poor surgical outcome in patients with cervical kyphosis. However, these results do not suggest that the type of cervical kyphosis influences the clinical outcome of surgery.
Keywords: cervical kyphosis, segmental kyphosis, global kyphosis, spinal cord injury, spinal cord surgery, poor outcome