전방 경추 수술에서 중앙선 설정의 정확성에 영향을 미치는 요인분석: 후향적 연구

초록

Study Design: This was a retrospective study. Objectives: The aim of this study was to investigate the factors associated with incorrect central line determination during anterior cervical surgery. Summary of Literature Review: Although central line determination in anterior cervical surgery usually does not significantly impact surgical outcomes, incorrect central line determination in specific procedures, such as corpectomy and vertebral body sliding osteotomy, can increase the risk of vertebral artery injury. In addition, improper central line determination during cervical disc arthroplasty can lead to mechanical failure after surgery. However, novice surgeons often struggle with accurate central line determination in these surgical procedures. Materials and Methods: A retrospective study was conducted on patients who underwent single-level anterior cervical discectomy from March 2021 to February 2024. Radiological examinations before and after surgery were used to measure the distance from the true central line to the center of the inserted cage. Patients were categorized according to whether the central line was accurately or inaccurately determined. In this study, we investigated the factors associated with incorrect central line determination. Results: Multivariate regression analysis revealed that a Pfirrmann grade of 5 (adjusted odds ratio [aOR]=12.507, p=0.049), uncinate process resection during surgery (aOR=13.574, p=0.036), and trachea deviation (aOR=4.685, p=0.016) were associated with incorrect central line determination. In contrast, patients with spinal cord problems were more likely to demonstrate a well-aligned central line (aOR=0.223, p=0.008). Conclusions: In patients with severe disc degeneration (Pfirrmann grade 5 or higher), trachea deviation, and those who undergo uncinate process resection during surgery, careful attention is needed, as establishing the central line may be challenging. © 2024 Korean Society of Spine Surgery Journal of Korean Society of Spine Surgery.

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