伴有上交叉综合征的青年颈型颈椎病患者的颈椎X线检查的初步分析
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摘要
目的:分析伴有上交叉综合征(upper crossed syndrome,UCS)的青年颈型颈椎病患者的X线特点。方法 :选取2017年1月至10月期间伴有和不伴有UCS的青年颈型颈椎病患者各20例,以及正常志愿者10例,予以颈椎侧位、前屈后伸位X线检查,观察颈椎夹角、角位移、相邻椎体滑移。结果:UCS组颈椎夹角为(-0.40±9.64)°,明显小于正常组的(14.35±9.01)°(P<0.05)和非UCS组的(9.55±14.69)°(P<0.05)。UCS组上颈椎前屈后伸位角位移变化为(8.18±4.81)°,明显小于正常组的(12.14±3.48)°(P<0.05)和非UCS组的(12.34±5.65)°(P<0.05)。UCS组前屈位下颈椎椎体后缘滑移为15.41±2.21,明显大于正常组的13.26±2.42(P<0.05),同非UCS组的15.64±2.07,差异无统计学意义(P>0.05)。结论:伴有UCS青年颈型颈椎病患者的颈椎生理曲度更倾向于变直或者反张,上颈椎屈伸活动受限,而下颈椎处于屈曲状态。
Objective:To analyze the X-ray characteristics in youth neck type of cervical spondylosis with upper crossed syndrome(UCS). Methods:The patients who had a neck type of cervical spondylosis with or without UCS were selected from January to October 2017,20 cases in each group,and 10 normal volunteers were chosen in the study. X-ray examination of lateral and hyperextension-hyperflexion of cervical spine were performed to observe cervical spine angle,angular displacement and adjacent vertebral body slip. Results:The cervical spine angle was(-0.40±9.64)° in the UCS group,significantly less than(14.35±9.01)° in the normal group and(12.34±5.65)° in the non-UCS group(P<0.05). The change of angular displacement of the upper cervical vertebra in anterior flexion and posterior extension was(8.18±4.81)° in UCS group,which was also significantly less than(12.14±3.48)° in the normal group and(12.34±5.65)° in the non-UCS group(P<0.05). The slippage of the vertebral posterior margin of the lower cervical spine in the anterior flexion was 15.41±2.21 in the UCS group,which was significantly greater than 13.26±2.42 in normal group(P<0.05),and was not obviously different from 15.64±2.07 in non-UCS group(P>0.05). Conclusion:In young patients who has a neck type of cervical spondylosis with UCS,the cervical curvature prone to straighten or reverse,the upper cervical flexion and extension are limited,while the lower cervical is in a flexion.
Objective:To analyze the X-ray characteristics in youth neck type of cervical spondylosis with upper crossed syndrome(UCS). Methods:The patients who had a neck type of cervical spondylosis with or without UCS were selected from January to October 2017,20 cases in each group,and 10 normal volunteers were chosen in the study. X-ray examination of lateral and hyperextension-hyperflexion of cervical spine were performed to observe cervical spine angle,angular displacement and adjacent vertebral body slip. Results:The cervical spine angle was(-0.40±9.64)° in the UCS group,significantly less than(14.35±9.01)° in the normal group and(12.34±5.65)° in the non-UCS group(P<0.05). The change of angular displacement of the upper cervical vertebra in anterior flexion and posterior extension was(8.18±4.81)° in UCS group,which was also significantly less than(12.14±3.48)° in the normal group and(12.34±5.65)° in the non-UCS group(P<0.05). The slippage of the vertebral posterior margin of the lower cervical spine in the anterior flexion was 15.41±2.21 in the UCS group,which was significantly greater than 13.26±2.42 in normal group(P<0.05),and was not obviously different from 15.64±2.07 in non-UCS group(P>0.05). Conclusion:In young patients who has a neck type of cervical spondylosis with UCS,the cervical curvature prone to straighten or reverse,the upper cervical flexion and extension are limited,while the lower cervical is in a flexion.
引文
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[6]张玉婷,王翔,詹红生.颈椎曲度的测量方法及其临床意义[J].中国骨伤,2014,27(12):1062-1064.ZHANG YT,WANG X,ZHAN HS. Measurement and clinical significance of cervical lordosis[J]. Zhongguo Gu Shang/China J Orthop Trauma,2014,27(12):1062-1064. Chinese with abstract in English.
[7]时宗庭,王庆甫,黄沪,等.青少年颈痛患者功能位X线分析[J].北京中医药大学学报(中医临床版),2010,17(6):32-35.SHI ZT,WANG QF,HUANG H,et al. Analysis on functional position X-ray in teenager patients with juvenile cervicodynia[J].Bei Jing Zhong Yi Yao Da Xue Xue Bao(Zhong Yi Lin Chuang Ban),2010,17(6):32-35. Chinese.
[8]Gleland J,Selleck B,Stowell T,et al. Short-term effects of thoracic manipulation on lower trapezius muscle strengh[J].J Man Manip Ther,2004,12(2):82-90.
[9] Bae WS,Lee HO,Shin JW,et al. The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome[J]. J Phys Ther Sci,2016,28:1636-1639.
[10] Valli J. Chiropractic management of a 46-year-old type 1 diabetic patient with upper crossed syndrome and adhesive capsulitis[J].J Chiropr Med, 2004,3(4):138-144.
[2]蔡冰,眭承志,陈舒强.上交叉综合征的病因及发病机制探讨[J].按摩与康复医学,2017,8(1):10-13.CAI B,SUI CZ,CHEN SQ. Research on the etiology and pathogenesis of upper crossed syndrome[J]. An Mo Yu Kang Fu Yi Xue, 2017,8(1):10-13. Chinese.
[3] Page P,Frank C,Lardner R.肌肉失衡的评估与治疗[M].北京:人民体育出版社,2 016:50-5 7.Page P,Frank C,Lardner R. Assessment and Treatment of Muscle Imbalance[M]. Beijing:People's Sports Publishing House,2016:50-57. Chinese.
[4]施加加,花佳佳,孙剑渊,等.肌肉能量技术联合常规康复训练治疗上交叉综合征患者的疗效观察[J].中国物理医学与康复杂志,2015,37(7):533-535.SHI JJ, HUA JJ, SUN JY, et al. Clinical observation of muscle energy techniques combined with conventional rehabilitation training in the treatment of patients with upper crossed syndrome[J]. Zhongguo Wu Li Yi Xue Yu Kang Fu Za Zhi,2015,37(7):533-535. Chinese.
[5] Gu SY,Hwangbo G,Lee JH. Relationship between position sense and reposition errors according to the degree of upper crossed syndrome[J]. J Phys Ther Soi,2016,28(2):438-441.
[6]张玉婷,王翔,詹红生.颈椎曲度的测量方法及其临床意义[J].中国骨伤,2014,27(12):1062-1064.ZHANG YT,WANG X,ZHAN HS. Measurement and clinical significance of cervical lordosis[J]. Zhongguo Gu Shang/China J Orthop Trauma,2014,27(12):1062-1064. Chinese with abstract in English.
[7]时宗庭,王庆甫,黄沪,等.青少年颈痛患者功能位X线分析[J].北京中医药大学学报(中医临床版),2010,17(6):32-35.SHI ZT,WANG QF,HUANG H,et al. Analysis on functional position X-ray in teenager patients with juvenile cervicodynia[J].Bei Jing Zhong Yi Yao Da Xue Xue Bao(Zhong Yi Lin Chuang Ban),2010,17(6):32-35. Chinese.
[8]Gleland J,Selleck B,Stowell T,et al. Short-term effects of thoracic manipulation on lower trapezius muscle strengh[J].J Man Manip Ther,2004,12(2):82-90.
[9] Bae WS,Lee HO,Shin JW,et al. The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome[J]. J Phys Ther Sci,2016,28:1636-1639.
[10] Valli J. Chiropractic management of a 46-year-old type 1 diabetic patient with upper crossed syndrome and adhesive capsulitis[J].J Chiropr Med, 2004,3(4):138-144.