颈椎病严重程度与颈椎曲度相关性的影像学研究
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摘要
目的探讨颈椎病严重程度与颈椎曲度的关系。方法随机抽取64例保守治疗无效需开放手术治疗的颈椎病患者作为手术组,同时从保守治疗有效颈椎病患者、在体检科无颈椎病正常人员中选取年龄及性别相匹配的64例分别作为保守治疗组、正常组,三组皆在颈椎侧位X线片上用Borden氏法、C2~C7Cobb角测量法及Harrison氏法测量颈椎曲度,并对所测量数值作统计学分析。结果 Borden氏法测量值、C2~C7Cobb角度、Harrison氏法测量值在三组比较均有统计学差异(P<0.05),手术组的Borden氏法测量值、C2~C7Cobb角度、Harrison氏法测量值均比正常组减小(P<0.05),手术组与保守治疗组、保守治疗组与正常组在各项颈椎曲度参数比较无统计学差异(P>0.05),手术组、保守治疗组及正常组颈椎曲度异常者分别占62.5%、46.9%、34.4%,三组颈椎曲度异常率比较有统计学差异(P=0.006)。结论患者颈椎病越严重其颈椎曲度异常率也越高,异常程度也越严重,在临床治疗中应意识到颈椎曲度的重要性。
Objective To explore the association between the severity of cervical spondylosis and cervical spine curvature. Methods 64 patients diagnosed as cervical spondylosis in our hospital who were not valid for conservative treatment and needed surgery were chosen randomly as the operation group. Meanwhile 64 age-and sex-matched patients diagnosed as cervical spondylosis valid for conservative treatment were chosen randomly as the conservative group. 64 age-and sexmatched people without cervical spondylosis were selected as normal group from people coming for routine physical examination. We measured the cervical spine curvature by the methods of Borden,C2-C7 Cobb angle and the method of Harrison on the cervical lateral X-ray. The measured values were statistically analyzed. Results There were statistical differences in the measured values by the method of Borden,C2-C7 Cobb angle and the method of Harrison of the three groups( P <0. 05). The measured values by the method of Borden,C2-C7 Cobb angle,and the method of Harrison in the operation group were lower significantly than the normal group( P < 0. 005). There were no statistical differences between the operation group and the conservative group or between the conservative group and the normal group( P > 0. 05). The percentages of abnormity of cervical spine curvature were respectively 62. 5%,46. 9% and 34. 4% in the operation group,the conservative group and the normal group. The percentage of abnormity of cervical spine curvature in the three groups were statistically significant( P = 0. 006). Conclusion The more severe cervical spondylosis,the higher the percentage of abnormity and the lower the cervical spine curvature. We should be aware of the importance of cervical spine curvature in clinical treatment.
Objective To explore the association between the severity of cervical spondylosis and cervical spine curvature. Methods 64 patients diagnosed as cervical spondylosis in our hospital who were not valid for conservative treatment and needed surgery were chosen randomly as the operation group. Meanwhile 64 age-and sex-matched patients diagnosed as cervical spondylosis valid for conservative treatment were chosen randomly as the conservative group. 64 age-and sexmatched people without cervical spondylosis were selected as normal group from people coming for routine physical examination. We measured the cervical spine curvature by the methods of Borden,C2-C7 Cobb angle and the method of Harrison on the cervical lateral X-ray. The measured values were statistically analyzed. Results There were statistical differences in the measured values by the method of Borden,C2-C7 Cobb angle and the method of Harrison of the three groups( P <0. 05). The measured values by the method of Borden,C2-C7 Cobb angle,and the method of Harrison in the operation group were lower significantly than the normal group( P < 0. 005). There were no statistical differences between the operation group and the conservative group or between the conservative group and the normal group( P > 0. 05). The percentages of abnormity of cervical spine curvature were respectively 62. 5%,46. 9% and 34. 4% in the operation group,the conservative group and the normal group. The percentage of abnormity of cervical spine curvature in the three groups were statistically significant( P = 0. 006). Conclusion The more severe cervical spondylosis,the higher the percentage of abnormity and the lower the cervical spine curvature. We should be aware of the importance of cervical spine curvature in clinical treatment.
引文
1 Vialle R,Levassor N,Rillardon L,et al.Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects[J].J Bone Joint Surg Am,2005,87:260-267.
2 Iyer S,Nemani VM,Nguyen J,et al.Impact of Cervical Sagittal Alignment Parameters on Neck Disability[J].Spine(Phila Pa1976),2016,41:371-377.
3 Scheer JK,Tang JA,Smith JS,et al.Cervical spine alignment,sagittal deformity,and clinical implications:a review[J].J Neurosurg Spine,2013,19:141-459.
4王涛,周理乾,孙孟锟,等.6种颈椎曲度测量方法的可信度及可重复性比较[J].中国脊柱脊髓杂志,2015,25:323-327.
5吴炳轩,刘宝戈,刘振宇,等.颈椎曲度和活动度参数的影响因素[J].中华骨科杂志,2014,34:380-386.
6张靖慧,孙大炜,黄晓琳.颈椎曲度测量方法进展与及临床意义[J].中国康复,2009,24:347-349.
7 Borden AG,Rechtman AM,Gershon-Cohen J.The normal cervical lordosis[J].Radiology,1960,74:806-809.
8陈银海,姚红华,杨忠.颈椎曲度的X线测量在颈椎病康复评定中的应用价值[J].中国康复,2007,22:156-458.
9 Harrison DE,Harrison DD,Cailliet R,et al.Cobb method or Harrison posterior tangent method:which to choose for lateral cervical radiographic analysis[J].Spine(Phila Pa 1976),2000,25:2072-2078.
10 Harrison DD,Troyanovich SJ,Harrison DE,et al.A normal sagittal spinal configuration:a desirable clinical outcome[J].J Manipulative Physiol Ther,1996,19:398-405.
11方文,石志才,贾连顺.颈椎病患者颈椎曲度的X线测量[J].颈腰痛杂志,1999,20:83-86.
12 Harrison DE,Harrison DD,Troyanovich SJ,et al.A normal spinal position:Its time to accept the evidence[J].J Manipulative Physiol Ther,2000,23:623-644.
13 Miyazaki M,Hymanson HJ,Morishita Y,et al.Kinematic analysis of the relationship between sagittal alignment and disc degeneration in the cervical spine[J].Spine(Phila Pa 1976),2008,33:E870-E876.
14叶国栋,王艳国.颈椎曲度异常与颈椎病的相关性[J].颈腰痛杂志,2014,35:154-456.
15曾科学,盖娟娟.颈椎生理曲度异常的影像学检查意义[J].现代中西医结合杂志,2012,21:2175-2176.
16任龙喜,何玉宝,郭函,等.颈部疼痛程度与颈椎曲度相关性的临床观察[J].中国脊柱脊髓杂志,2011,21:750-753.
17周永富,王志宏,杜婷,等.颈椎曲度与颈痛相关性的临床研究[J].颈腰痛杂志,2015,36:406-409.
2 Iyer S,Nemani VM,Nguyen J,et al.Impact of Cervical Sagittal Alignment Parameters on Neck Disability[J].Spine(Phila Pa1976),2016,41:371-377.
3 Scheer JK,Tang JA,Smith JS,et al.Cervical spine alignment,sagittal deformity,and clinical implications:a review[J].J Neurosurg Spine,2013,19:141-459.
4王涛,周理乾,孙孟锟,等.6种颈椎曲度测量方法的可信度及可重复性比较[J].中国脊柱脊髓杂志,2015,25:323-327.
5吴炳轩,刘宝戈,刘振宇,等.颈椎曲度和活动度参数的影响因素[J].中华骨科杂志,2014,34:380-386.
6张靖慧,孙大炜,黄晓琳.颈椎曲度测量方法进展与及临床意义[J].中国康复,2009,24:347-349.
7 Borden AG,Rechtman AM,Gershon-Cohen J.The normal cervical lordosis[J].Radiology,1960,74:806-809.
8陈银海,姚红华,杨忠.颈椎曲度的X线测量在颈椎病康复评定中的应用价值[J].中国康复,2007,22:156-458.
9 Harrison DE,Harrison DD,Cailliet R,et al.Cobb method or Harrison posterior tangent method:which to choose for lateral cervical radiographic analysis[J].Spine(Phila Pa 1976),2000,25:2072-2078.
10 Harrison DD,Troyanovich SJ,Harrison DE,et al.A normal sagittal spinal configuration:a desirable clinical outcome[J].J Manipulative Physiol Ther,1996,19:398-405.
11方文,石志才,贾连顺.颈椎病患者颈椎曲度的X线测量[J].颈腰痛杂志,1999,20:83-86.
12 Harrison DE,Harrison DD,Troyanovich SJ,et al.A normal spinal position:Its time to accept the evidence[J].J Manipulative Physiol Ther,2000,23:623-644.
13 Miyazaki M,Hymanson HJ,Morishita Y,et al.Kinematic analysis of the relationship between sagittal alignment and disc degeneration in the cervical spine[J].Spine(Phila Pa 1976),2008,33:E870-E876.
14叶国栋,王艳国.颈椎曲度异常与颈椎病的相关性[J].颈腰痛杂志,2014,35:154-456.
15曾科学,盖娟娟.颈椎生理曲度异常的影像学检查意义[J].现代中西医结合杂志,2012,21:2175-2176.
16任龙喜,何玉宝,郭函,等.颈部疼痛程度与颈椎曲度相关性的临床观察[J].中国脊柱脊髓杂志,2011,21:750-753.
17周永富,王志宏,杜婷,等.颈椎曲度与颈痛相关性的临床研究[J].颈腰痛杂志,2015,36:406-409.