Analysis Of Population Characteristics And Risk Factors Of Cervical Spondylosis Myelopathy Patients With Ligamentum Flavum Hypertrophy

BackgroundDegenerative cervical spondylosis is the most common cause of cervical spinal cord and nerve function impairment in adults.According to reports,ligamentum flavum hypertrophy is one of the main causes of cervical spondylosis,which seriously affects the quality of daily life of the middle-aged and elderly people.At present,the mainstream view on the study of ligamentous ligament hypertrophy is that the dual factors of ligamentum flavum tissue degeneration and abnormal activity of local segments lead to the occurrence of ligamentous ligament hypertrophy.However,there is some controversy in the discussion of its specific related risk factors.Based on the current controversy in risk factors related to ligamentum flavum hypertrophy and the research on factors related to ligamentum flavum hypertrophy,the majority of research exists in the field of lumbar ligamentum flavum,while the research on cervical ligamentum flavum hypertrophy is still lacking.The characteristics analysis of the cervical spine patient population related to ligamentum flavum hypertrophy and discussion between the ligamentum flavum hypertrophy and other degenerative changes of the cervical spine can contribute to understanding how ligamentum flavum hypertrophy occur in the process of cervical degeneration,explore the related risk factors of cervical ligamentum flavum hypertrophy.ObjectiveTo investigate the characteristics of cervical spondylosis patients with cervical ligamentum flavum hypertrophy,and explore the risk factors of cervical ligamentum flavum hypertrophy.MethodsThe relevant data of degenerative cervical spondylosis patients associated with ligamentum flavum hypertrophy who underwent surgical treatment from January 2015 to December 2018 in the Department of Spinal Surgery,Zhongda Hospital affiliated to Southeast University were collected.154 patients were enrolled in this study,including 50 patients with a single segment and 104 patients with multi-segment hypertrophy.General information were collected,such as age,gender,Body Mass Index(BMI),prevalence of diabetes,and the spinal cord signals changes in Magnetic Resonance Imaging(MRI).t-test and chi-square test were performed on the above parameters for univariate analysis,which was statistical significant with P values<0.05.This was conducted to clarify the basic characteristics of cervical ligamentum flavum hypertrophy population;A total of611 intervertebral disc degeneration degree,facet joint degeneration degree,intervertebral height,intervertebral width,nuchal ligament calcification,osseous spinal canal diameter and cervical spine instability were collected from the 154 patients with C3 / 4-C6 / 7 levels.Its were divided into the ligamentum hypertrophy group(332 cases)and the non-yellow ligament hypertrophy group(279cases)according to whether the corresponding intervertebral space had ligamentum flavum hypertrophy.Using R language to perform univariate and full-variable unconditional Logisitic fitting of the obtained intervertebral space-related parameters,which was statistically significant with P<0.05,to explore the relevant risk factors of cervical ligamentum flavum hypertrophy.ResultsThe average age of the overall population was 59.08 ± 10.63 years,the gender ratio(male:female)was 122: 32,and the BMI was 24.49 ± 3.14 kg / ㎡,18% of the population had type II-diabetes,51.4% of the population had changes in spinal cord signals,and 53.2% of the population had nuchal ligament calcification;The group of multi-segment ligamentum flavum hypertrophy was older than the single-segment group(53.4 ± 10.16 vs 61.6 ± 9.99,P <0.05).A total of 611 intervertebral space related parameters were included in this study,of which 332 were in the ligamentum flavum hypertrophy group and 279 were in the non-ligamentum flavum.The results of univariate analysis showed that the degree of intervertebral disc degeneration,nuchal ligament calcification,osseous spinal canal diameter,intervertebral height,and degree of articular process joint degeneration were statistically different between the two groups(P <0.05).and the results of multivariate non-conditional logisitic analysis showed that intervertebral height(OR=0.77,P <0.05)and grade III facet joint degeneration(OR=3.943,P <0.05)were statistically different between the two groups(P <0.05).It can be considered that the reduction of intervertebral height and grade III facet joint degeneration were the risk factors for cervical ligamentum flavum hypertrophy in the corresponding levels;ROC curve of intervertebral height was drew,and the Youden index was0.143,the cut-off value was 4.345 mm,the corresponding sensitivity was 0.774,and the specificity was 0.369.ConclusionAs a degenerative change in spine,cervical ligamentum flavum hypertrophy is related to age.With the increase of age,there is a tendency to develop from a single segment to multiple segments.Male,the calcification of nuchae ligament and the MRI spinal cord signals may point the higher risk of cervical ligament hypertrophy to some extent.Reduction of intervertebral height and grade III facet joint degeneration(hypertrophy of small joints caused by large osteophytes,but not fused)were the risk factors for cervical ligamentum flavum hypertrophy in the corresponding levels.