脊髓型颈椎病术前颈长肌容积与前路椎间盘切除融合术疗效的关系

王磊鑫; 田夏威; 臧全金

doi:10.11659/jjssx.04E025079

您当前的位置：

首页 >

文章列表页 >

脊髓型颈椎病术前颈长肌容积与前路椎间盘切除融合术疗效的关系

骨科专栏 | 更新时间：2026-04-20

- 脊髓型颈椎病术前颈长肌容积与前路椎间盘切除融合术疗效的关系
- Relationship between preoperative longus colli muscle volume and postoperative efficacy of anterior cervical discectomy and fusion in patients with cervical spondylotic myelopathy
- 局解手术学杂志 2026年35卷第4期页码：298-302
- 作者机构：
  
  西安国际医学中心医院脊柱外科，陕西西安 710100
- 作者简介：
  
  田夏威，E-mail：745029303@qq.com
- 基金信息：
  
  陕西省科技计划项目(2021SF-105)
- DOI：10.11659/jjssx.04E025079
  中图分类号： R681.5
- 收稿：2025-04-15，
  
  纸质出版：2026-04-25
- 稿件说明：
移动端阅览
王磊鑫,田夏威,臧全金.脊髓型颈椎病术前颈长肌容积与前路椎间盘切除融合术疗效的关系[J].局解手术学杂志,2026,35(04):298-302.

WANG Lei-xin,TIAN Xia-wei,ZANG Quan-jin.Relationship between preoperative longus colli muscle volume and postoperative efficacy of anterior cervical discectomy and fusion in patients with cervical spondylotic myelopathy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(04):298-302.
王磊鑫,田夏威,臧全金.脊髓型颈椎病术前颈长肌容积与前路椎间盘切除融合术疗效的关系[J].局解手术学杂志,2026,35(04):298-302. DOI： 10.11659/jjssx.04E025079.

WANG Lei-xin,TIAN Xia-wei,ZANG Quan-jin.Relationship between preoperative longus colli muscle volume and postoperative efficacy of anterior cervical discectomy and fusion in patients with cervical spondylotic myelopathy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(04):298-302. DOI： 10.11659/jjssx.04E025079.

摘要

目的

探讨术前颈长肌容积与脊髓型颈椎病（CSM）患者颈椎前路椎间盘切除融合术（ACDF）疗效的关系。

方法

选取2022年9月至2023年9月我院收治的151例拟行ACDF治疗的CSM患者，术前均接受磁共振（MRI）扫描测量颈长肌容积，根据术后12个月的手术疗效将患者分为疗效优秀组和疗效欠佳组。采用日本骨科协会（JOA）评分、颈椎病临床评价量表（CASCS）、颈椎功能障碍指数（NDI）评价患者颈椎功能恢复情况。采用

Pearson

分析术前颈长肌容积与术后颈椎功能的相关性。采用多因素

Logistic

回归分析影响CSM患者ACDF疗效的因素，采用受试者工作特征（

ROC

）曲线分析术前颈长肌容积预测CSM患者ACDF疗效的价值。

结果

151例患者中失访2例，其余149例CSM患者中手术疗效优83例，良32例，可30例，差4例。疗效欠佳组患者术前颈长肌容积小于疗效优秀组（

0.05），术后JOA、CASCS评分低于疗效优秀组（

0.05），NDI评分高于疗效优秀组（

0.05）。CSM患者术前颈长肌容积与术后JOA、CASCS评分呈正相关（

=0.512、0.423，

0.05），与NDI评分呈负相关（

=-0.597，

0.05）。多因素

Logistic

回归分析显示，术后椎间隙高度增加、术前颈长肌容积较大是CSM患者ACDF疗效的保护因素（

0.05）。术前颈长肌容积预测CSM患者ACDF术后疗效的临界值为8 265.82 mm

，曲线下面积为0.895，敏感度为90.70%，特异度为87.30%。

结论

CSM患者术前颈长肌容积偏小与ACDF疗效不佳有关，术前通过MRI测量颈长肌容积或可作为评估ACDF疗效的一个潜在参考指标。

Abstract

Objective

To explore the relationship between preoperative longus colli muscle volume and the postoperative efficacy of anterior cervical discectomy and fusion （ACDF） in patients with cervical spondylotic myelopathy （CSM）.

Methods

A total of 151 CSM patients who scheduled to undergo ACDF treatment in our hospital from September 2022 to September 2023 were selected.All patients received magnetic resonance imaging （MRI） scans before surgery to measure the volume of the longus colli muscle. The patients were divided into the excellent efficacy group and the poor efficacy group according to the surgical efficacy at 12 months postoperatively.The Japanese Orthopaedic Association （JOA） score，clinical

assessment scale for cervical spondylosis （CASCS），and neck disability index （NDI） were used to evaluate the recovery of the cervical spine function of patients.

Pearson

analysis was performed to assess the correlation between preoperative longus colli muscle volume and postoperative cervical spine function.Multivariate

Logistic

regression was used to analyze the factors affecting the therapeutic efficacy of ACDF in CSM patients.The

receiver operating characteristic

（

ROC

） curve was used to analyze the value of preoperative longus colli muscle volume in predicting the therapeutic efficacy of ACDF in CSM patients.

Results

Of the 151 patients，2 were lost to follow-up.Among the remaining 149 CSM patients after ACDF，83 had excellent outcome，32 good，30 acceptable，and 4 poor. In the poor efficacy group，the preoperative longus colli muscle volume was smaller than that in the excellent efficacy group （

0.05）， the postoperative JOA and CASCS scores were lower than those in the excellent efficacy group （

0.05），while the NDI score was higher than that in the excellent efficacy group （

0.05）.The preoperative longus colli muscle volume in CSM patients was positively correlated with the postoperative JOA and CASCS scores （

=0.512，0.423，

0.05），and negatively correlated with the NDI score （

=-0.597，

0.05）.Multivariate

Logistic

regression analysis showed that increased postoperative intervertebral space height and larger preoperative longus colli muscle volume were protective factors for ACDF efficacy in patients with CSM （

0.05）.The critical value of preoperative longus colli muscle volume for predicting the postoperative efficacy of ACDF in CSM patients was 8 265.82 mm³，with an

area under the curve

of 0.895，a sensitivity of 90.70%，and a specif

icity of 87.30%.

Conclusion

Smaller preoperative longus colli muscle volume in CSM patients is associated with poor efficacy of ACDF.Preoperative measurement of longus colli muscle volume by MRI may serve as a potential reference indicator for evaluating the efficacy of ACDF.

关键词

Keywords

references

Sharma S ， Sial A ， Sima S ， et al . Clinical signs and symptoms for degenerative cervical myelopathy：a scoping review of case-control studies to facilitate early diagnosis among healthcare professionals with stakeholder engagement ［J］. Spinal Cord ， 2025 ， 63 （ 3 ）： 171 - 180 . doi： 10.1038/s41393-025-01065-1 http://dx.doi.org/10.1038/s41393-025-01065-1 .

Chen L ， Zhang Z ， Li J ， et al . Meta-analysis of treatment for adjacent two-segment cervical spondylotic myelopathy：a comparison between anterior cervical corpectomy and fusion and anterior cervical discectomy and fusion ［J］. Global Spine J ， 2025 ， 15 （ 3 ）： 1839 - 1848 . doi： 10.1177/21925682241297586 http://dx.doi.org/10.1177/21925682241297586 .

Xiao J ， Deng G ， Ling H ， et al . Constructing a nomogram model for patients with cervical spondylotic myelopathy ［J］. Sci Rep ， 2025 ， 15 （ 1 ）： 8901 . doi： 10.1038/s41598-025-93703-0 http://dx.doi.org/10.1038/s41598-025-93703-0 .

汤洋，黄觅，胡敏，等 . 脊髓型颈椎病经ACDF术后临床疗效与颈椎矢状位参数变化的相关性分析［J］. 中国骨与关节损伤杂志， 2021 ， 36 （ 9 ）： 932 - 934 . doi： 10.7531/j.issn.1672-9935.2021. 09.011 http://dx.doi.org/10.7531/j.issn.1672-9935.2021.09.011 .

陆海涛，于海洋，张伟，等 . 伴颈椎后凸畸形的脊髓型颈椎病影像学特征与手术疗效分析［J］. 中国修复重建外科杂志， 2024 ， 38 （ 5 ）： 542 - 549 . doi： 10.7507/1002-1892.202402018 http://dx.doi.org/10.7507/1002-1892.202402018 .

章书豪，陈衍，厉浩斌，等 . 颈长肌血管来源与分布及临床意义［J］. 中国脊柱脊髓杂志， 2023 ， 33 （ 7 ）： 639 - 643 . doi： 10.3969/j.issn.1004-406X.2023.07.09 http://dx.doi.org/10.3969/j.issn.1004-406X.2023.07.09 .

Snodgrass SJ ， Stanwell P ， Weber KA ， et al . Greater muscle volume and muscle fat infiltrate in the deep cervical spine extensor muscles （multifidus with semispinalis cervicis） in individuals with chronic idiopathic neck pain compared to age and sex-matched asymptomatic controls：a cross-sectional study ［J］. BMC Musculoskelet Disord ， 2022 ， 23 （ 1 ）： 973 . doi： 10.1186/s12891-022-05924-3 http://dx.doi.org/10.1186/s12891-022-05924-3 .

中华外科杂志编辑部 . 颈椎病的分型、诊断及非手术治疗专家共识（2018）［J］. 中华外科杂志， 2018 ， 56 （ 6 ）： 401 - 402 . doi： 10.3760/cma.j.issn.0529-5815.2018.06.001 http://dx.doi.org/10.3760/cma.j.issn.0529-5815.2018.06.001 .

Fehlings MG ， Wilson JR ， Kopjar B ， et al . Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy：results of the AOSpine North America prospective multi-center study ［J］. J Bone Joint Surg Am ， 2013 ， 95 （ 18 ）： 1651 - 1658 . doi： 10.2106/JBJS.L.00589 http://dx.doi.org/10.2106/JBJS.L.00589 .

邱颖，廖静，徐祖琳，等 . 退行性脊髓型颈椎病患者术前颈椎矢状面参数与临床结局的相关性［J］. 广西医科大学学报， 2023 ， 40 （ 7 ）： 1218 - 1223 . doi： 10.16190/j.cnki.45-1211/r.2023.07.021 http://dx.doi.org/10.16190/j.cnki.45-1211/r.2023.07.021 .

张鸣生，许伟成，林仲民，等 . 颈椎病临床评价量表的信度与效度研究［J］. 中华物理医学与康复杂志， 2003 ， 25 （ 3 ）： 151 - 154 . doi： 10.3760/j：issn：0254-1424.2003.03.007 http://dx.doi.org/10.3760/j：issn：0254-1424.2003.03.007 .

伍少玲，马超，伍时玲，等 . 颈椎功能障碍指数量表的效度与信度研究［J］. 中国康复医学杂志， 2008 ， 23 （ 7 ）： 625 - 628 . doi： 10.3969/j.issn.1001-1242.2008.07.017 http://dx.doi.org/10.3969/j.issn.1001-1242.2008.07.017 .

Li Z ， Zhang B ， Fang B ， et al . Finite element analysis of a three-dimensional cervical spine model with muscles based on CT scan data ［J］. Comput Methods Biomech Biomed Engin ， 2025 ， 28 （ 16 ）： 2463 - 2473 . doi： 10.1080/10255842.2024.2373928 http://dx.doi.org/10.1080/10255842.2024.2373928 .

Prodoehl J ， Pathak R ， Glavanovits J ， et al . Promoting longus colli muscle activation：force direction in sitting matters ［J］. Musculoskelet Sci Pract ， 2025 ， 76 ： 103269 . doi： 10.1016/j.msksp.2025.103269 http://dx.doi.org/10.1016/j.msksp.2025.103269 .

Sono T ， Ijiri K ， Kakehi K ， et al . The cross-sectional areas and anterior-posterior balance of the cervical paraspinal muscles in dropped head syndrome and cervical spondylotic myelopathy：a propensity score-matched analysis ［J］. JOR Spine ， 2025 ， 8 （ 1 ）： e70047 . doi： 10.1002/jsp2.70047 http://dx.doi.org/10.1002/jsp2.70047 .

Hou X ， Lu S ， Wang B ， et al . Morphologic characteristics of the deep cervical paraspinal muscles in patients with single-level cervical spondylotic myelopathy ［J］. World Neurosurg ， 2020 ， 134 ： e166 - e171 . doi： 10.1016/j.wneu.2019.09.162 http://dx.doi.org/10.1016/j.wneu.2019.09.162 .

杨帅，郭柱，相宏飞，等 . 颈椎前路椎间盘切除融合术后颈长肌、颈伸肌变化与临床疗效的相关性［J］. 中华骨科杂志， 2022 ， 42 （ 2 ）： 111 - 120 . doi： 10.3760/cma.j.cn121113-20210728-00486 http://dx.doi.org/10.3760/cma.j.cn121113-20210728-00486 .

Sun C ， Xiang H ， Wu X ， et al . The influence of anterior cervical discectomy and fusion surgery on cervical muscles and the correlation between related muscle changes and surgical efficacy ［J］. J Orthop Surg Res ， 2024 ， 19 （ 1 ）： 187 . doi： 10.1186/s13018-024-04605-2 http://dx.doi.org/10.1186/s13018-024-04605-2 .

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

3D打印技术在植骨融合手术治疗脊髓型颈椎病中的应用

颈椎前路椎间盘切除融合术后住院时间延长预测模型的建立与验证

Zero-p与Cage钛板融合术后椎前软组织肿胀程度与吞咽困难的关联研究