CAJ | 학술논문

目的：了解椎前软组织肿胀和手术范围、手术节段及相关并发症之间的关联,探讨侧位X线在椎前软组织肿胀评估中的临床意义。方法侧位X线测量计算123例颈椎前路融合术患者的椎前软组织肿胀宽度,按照C3水平椎前软组织肿胀宽度9.98 mm为分界,将病例分为肿胀组(大于9.98 mm)61例和非肿胀组(小于9.98 mm)62例,比较分析吞咽困难、呼吸困难等并发症的发生情况。结果肿胀组术后呼吸困难发生率为21.3%,高于非肿胀组的8.1%,差异有统计学意义(P<0.05)；肿胀组术后吞咽困难发生率为83.6%,高于非肿胀组的25.8%,差异有统计学意义(P<0.05)。单节段手术后椎前软组织肿胀平均为8.29 mm,明显低于双节段和多节段手术(11.55 mm和10.40 mm),差异有统计学意义(P<0.05)。高节段手术后(C4以上)椎前软组织肿胀为10.94 mm,明显高于低节段手术后(C5及以下)的8.63 mm(P<0.05)。结论颈椎前路融合术患者术后椎前软组织肿胀程度较高时术后吞咽困难和呼吸困难等并发症发生率也较高；多节段手术或高节段( C5以上)手术患者术后椎前软组织肿胀程度较高。因此,根据颈椎侧位X线评估椎前软组织肿胀程度具有一定的临床意义。
목적：료해추전연조직종창화수술범위、수술절단급상관병발증지간적관련,탐토측위X선재추전연조직종창평고중적림상의의。방법측위X선측량계산123례경추전로융합술환자적추전연조직종창관도,안조C3수평추전연조직종창관도9.98 mm위분계,장병례분위종창조(대우9.98 mm)61례화비종창조(소우9.98 mm)62례,비교분석탄인곤난、호흡곤난등병발증적발생정황。결과종창조술후호흡곤난발생솔위21.3%,고우비종창조적8.1%,차이유통계학의의(P<0.05)；종창조술후탄인곤난발생솔위83.6%,고우비종창조적25.8%,차이유통계학의의(P<0.05)。단절단수술후추전연조직종창평균위8.29 mm,명현저우쌍절단화다절단수술(11.55 mm화10.40 mm),차이유통계학의의(P<0.05)。고절단수술후(C4이상)추전연조직종창위10.94 mm,명현고우저절단수술후(C5급이하)적8.63 mm(P<0.05)。결론경추전로융합술환자술후추전연조직종창정도교고시술후탄인곤난화호흡곤난등병발증발생솔야교고；다절단수술혹고절단( C5이상)수술환자술후추전연조직종창정도교고。인차,근거경추측위X선평고추전연조직종창정도구유일정적림상의의。
Objective To explore the relationship among the prevertebral soft tissue swelling, surgical extent, surgical segments, and complications and to investigate the clinical significance of lateral radiographs for evaluating the postoperative prevertebral soft tissue swelling. Methods 123 patients who underwent anterior cervical fusion with plate augmentation for cervical spondylosis were included in this study. The postoperative prevertebral soft tissue swelling was measured by lateral radiographs. The data were analysed according to surgical extent and surgical segments. Patients were divided into the swelling group (61cases, >9. 98 mm) and the non-swelling group (62 cases, <9. 98 mm) based on the degree of prevertebral soft tissue swelling. The incidences of complications, such as dyspnea and dysphagia, were ana-lysed. Results The rate of dyspnea was 21. 3% in swelling group, which was higher than 8. 1% in non-swelling group (P<0. 05). The rate of dysphagia was 83. 6% in swelling group, which was higher than 25. 8% in non-swelling group (P<0. 05). In addition, postoperative prevertebral soft tissue swelling was 8. 29 mm averagely after one-level fusion, which was less than that after two or more levels fusion (11. 55 mm and 10. 40 mm) (P<0. 05). Postoperative prevertebral soft tissue swelling was 10. 94 mm after high-level fusion (above C4), which was more than that low-level fusion (below C5) (8. 63 mm) (P<0. 05). Conclusion After anterior cervical fusion for cervical spondylosis, when the degree of prevertebral soft tissue swelling is greater the incidences of complications such as dyspnea and dysphagia might be higher. In addition, prevertebral soft tissue swelling increments are significantly greater in patients who had undergone multi-level or high-level fusion ( above C5 ) . Evaluation of prevertebral soft tissue swelling using lateral radiographs is a clinically meaningful procedure.