摘要
背景:脊髓型颈椎病会导致颈椎矢状位参数的改变,造成严重的临床症状。由于颈椎的灵活性,仅通过某一颈椎矢状面参数测量的结果不一定具有说服力。目的:探讨脊髓型颈椎病患者的C2-C7 Cobb角与颈椎矢状面参数的相关性以及责任椎间隙高度、椎间成角与颈椎曲度的相关性。方法:收集75例脊髓型颈椎病患者的临床资料进行回顾性病例对照研究,男38例,女37例,年龄60~67岁,平均(64.2±2.1)岁。根据C2-C7 Cobb角测量数据分为两组。评价影像学结果,Jackson应力切线法测量的颈椎生理曲度、颈部倾斜、T1斜度、胸廓入口角、C2-C7矢状面垂直轴、C7斜度、责任椎间隙的活动度、高度和角度。结果:在颈椎矢状面参数中,除胸廓入口角与C2-C7 Cobb角无相关性,其他参数和C2-C7 Cobb角之间均有一定的相关性,其中T1斜度与C2-C7 Cobb角的相关性最强。C4/5、C5/6、C6/7节段的椎间隙高度和椎间成角与C2-C7 Cobb角显著相关。但在C3/4节段,只有椎间成角随C2-C7 Cobb角的增大而增大。结论:颈椎矢状面各参数是衡量颈椎间盘退行性改变的重要参考数据,颈椎椎间高度和椎间成角均影响颈椎曲度的变化。对于脊髓型颈椎病患者,在评估颈椎正常弯曲度时,除胸廓入口角,其他颈椎矢状面参数与C2-C7 Cobb角相当;但椎间成角比椎间高度更有意义。
Background:Cervical spondylotic myelopathy(CSM)leads to the changes of sagittal parameters of cervical vertebrae,resulting in severe clinical symptoms.Due to the flexibility of cervical vertebrae,the results measured only by the parameters of a certain sagittal plane of cervical vertebra are not necessarily convincing.Objective:To investigate whether the C2-7 Cobb angle in CSM patients has any correlation with the sagittal plane parameters of cervical spine,as well as the correlation between the responsible intervertebral space height and intervertebral angulation and cervical curvature.Methods:Clinical data of CSM 75 patients were collected for a retrospective case-control study,including 38 males and 37 females with a mean age of(64.2±2.1)years(range,60-67 years).These patients were divided into 2 groups according to the C2-7 Cobb angle.Jackson stress tangent method was used to measure cervical physiological curve,neck tilt(NT),T1 slope(T1S),thoracic inlet angle(T1A),C2-C7 sagittal vertical axis(C2-7 SVA),C7 slope(C7S),range of motion of the joint(ROM),and the height and angle of intervertebral space.Results:There was a certain correlation between C2-7 Cobb angle and the parameters of cervical sagittal plane(especially T1S),except for TIA.C2-C7 Cobb angle was positively correlated with intervertebral space height and angle of C4/5,C5/6 and C6/7 segments.However,only intervertebral angle increased with the increase of C2-C7 Cobb angle at C3/4 segment.Conclusions:Each parameter of cervical sagittal plane is an important reference factor to assess the degenerative change of cervical disc.In CSM patients,in terms of evaluating the normal curvature of the cervical spine,except for TIA,other sagittal plane parameters in this study are similar to C2-C7 Cobb angle.Intervertebral angle may be more important to evaluate cervical curvature than intervertebral height in CMS patients.
作者
周乾坤
牛国旗
赵保印
程嘉伟
周功
陈辉
刘路坦
ZHOU Qiankun;NIU Guoqi;ZHAO Baoyin;CHENG Jiawei;ZHOU Gong;CHEN Hui;LIU Lutan(Department of Spine Surgery,Second Affiliated Hospital of Bengbu Medical College,Bengbu 233000,Anhui,China)
出处
《中华骨与关节外科杂志》
2020年第10期813-818,共6页
Chinese Journal of Bone and Joint Surgery
基金
安徽省重点研究和开发计划项目:3D打印个体化定制枕颈融合内固定系统的研发与实验研究(1804h08020247)
关键词
脊髓型颈椎病
颈椎曲度
颈椎矢状面
椎间高度
椎间成角
Cervical Spondylotic Myelopathy
Cervical Curvature
Cervical Sagittal Plane
Intervertebral Height
Intervertebral Angle
