宁夏固原地区回族正常人群颈椎管形态学特点研究
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摘要
目的1.探讨宁夏固原地区正常回族人群颈椎管的形态学特点。2.确定宁夏固原地区回族人群颈椎SDD、VB和Torg Ratio的正常值范围。方法选取2007年7月至2008年7月选择所有固原市及泾源县人民医院的医疗卫生人员、所有患者及患者家属作为研究对象共486例,回族285例,其中男性155例,平均年龄40.2±13.7,女性130例,平均年龄39.0±12.7;汉族201例,其中男性98例,平均年龄39.2±12.6,女性103例,平均年龄38.7±11.8,所有研究对象在本地居住年限≥20年,均采用X线标准球管距离在180cm条件下颈椎侧位摄像。采用颈椎X线侧位片测量椎管矢状径(SDD)、椎体矢状径(VB),计算椎管比率(Torg Ratio),并按临床诊断是否为颈椎病分组,比较回族人群及与汉族人群之间颈椎管形态学的差异。结果回族男女SDD均值分别为:C3:17.24mm和16.49mm;C4:16.11mm和15.48mm;C5:16.29mm和15.64mm;C6:16.67mm和15.67mm;C7:16.37mm和15.58mm。汉族男女SDD均值分别为:C3:16.42mm和15.41mm;C4:15.54mm和14.70mm;C5:15.85mm和14.91mm;C6:16.03mm和15.02mm;C7:16.00mm和15.34mm,回汉男女SDD值在C4节段均为最小,C3节段均值最大;回族男女VB均值分别为:V3:17.67mm和16.18mm;V4:17.51mm和16.06mm;V5:17.42mm和16.04mm;V6:18.25mm和16.87mm;V7:19.12mm和17.47mm;汉族男女VB均值分别为:V3:17.58mm和16.21mm;V4:17.63mm和16.04mm;V5:17.61mm和15.96mm;V6:18.21mm和16.77mm;V7:19.25mm和17.05mm;回族男女Torg Ratio均值分别为:C3:0.98和1.03;C4:0.93和0.97;C5:0.94和0.98;C6:0.92和0.93;C7:0.86和0.90;汉族男女Torg Ratio均值分别为:C3:0.94和0.96;C4:0.89和0.92;C5:0.91和0.94;C6:0.89和0.90;C7:0.84和0.90;C7节段Torg Ratio最小。回族男性SDD和VB均显著大于女性(P=0.00)但女性Torg Ratio除C6节段外,均显著大于男性(P<0.01),回族人群SDD、Torg Ratio均大于汉族人群。结论宁夏回族正常人群颈椎管形态学特点不同于汉族人群,并且同民族不同性别之间也存在差异,颈椎病组SDD、Torg Ratio明显小于非颈椎病组。
Objective 1. To explore the morphometry of the cervical spinal canal between normal hui population in Ningxia Guyuan. 2.To determine the range of the normal values of SDD、VB and Torg Ratio of the Hui population of Guyuan ragion of Ningxia Hui Autonomous region. Methods 486 consecutive patients who were admitted to the Emergency Department of Ningxia Guyuan and Jingyuan People's Hospital from July 2007 to July 2008. 285 cases of Hui Nationality: male 155 cases, mean age 40.2±13.7, female 130 cases, mean age 39.0±12.7; 201 cases of Han Nationality, male 98 cases, mean age 39.2±12.6;female 103 cases, mean age 38.7±11.8, all the patients have lived in Ningxia at least 20 years, and the lateral radiographs of the cervical spine were taken in a standardized manner with a 180cm film-to-tube distance. Take the lateral cervical X-ray, measurements of the sagittal developmental diameter(SDD)、vertebral body diameter(VB) and calculate the Torg Ratio (SDD/VB), then grouped by if they are cervical spondylosis, compare the morphology of the cervical spinal canal of Hui nationality with Han nationality. Results The average of SDD in males and females of Hui Nationality are: C3: 17.24mm and 16.49mm; C4: 16.11mm and 15.48mm; C5: 16.29mm and 15.64mm; C6: 16.67mm and 15.67mm; C7: 16.37mm and 15.58mm; The average of SDD in males and females of Han Nationality are: C3: 16.42mm and 15.41mm; C4: 15.54mm and 14.70mm; C5: 15.85mm and 14.91mm; C6: 16.03mm and 15.02mm; C7: 16.00mm and 15.34mm, The largest SDD is C3 in both Hui and Han Nationality and males and females, C4 is the smallest. The average of VB in males and females of Hui Nationality are: V3: 17.67mm and 16.18mm; V4: 17.51mm and 16.06mm; V5: 17.42mm and 16.04mm; V6: 18.25mm and 16.87mm; V7: 19.12mm and 17.58mm; The average of VB in males and females of Han Nationality are: V3: 17.67mm and 16.21mm; V4: 17.63mm and 16.04mm; V5: 17.61mm and 15.96mm; V6: 18.21mm and 16.77mm; V7: 19.25mm and 17.05mm; The average of Torg Ratio in males and females of Hui Nationality are: C3: 0.98 and 1.03; C4: 0.93 and 0.97; C5: 0.94 and 0.98; C6: 0.92 and 0.93; C7: 0.86 and 0.90; The average of Torg Ratio in males and females of Hui Nationality are: C3: 0.94 and 0.96; C4: 0.89 and 0.92; C5: 0.91 and 0.94; C6: 0.89 and 0.90; C7: 0.84 and 0.90; SDD and VB in males are significantly lager than those in females.(P=0.00),Torg Ratio in females is significantly larger than that in males.(P≤0.01). Except the C6 level, SDD and VB in Hui Nationality are larger than those in Han Nationality. Conclusion The morphology of the cervical spinal canal of Hui Nationality in Ningxia is different from that of the Han Nationality besides gender differences.The SDD、Torg Ratio in cervical spondylosis group are significantly smaller than those in the nonspondylosis group.
Objective 1. To explore the morphometry of the cervical spinal canal between normal hui population in Ningxia Guyuan. 2.To determine the range of the normal values of SDD、VB and Torg Ratio of the Hui population of Guyuan ragion of Ningxia Hui Autonomous region. Methods 486 consecutive patients who were admitted to the Emergency Department of Ningxia Guyuan and Jingyuan People's Hospital from July 2007 to July 2008. 285 cases of Hui Nationality: male 155 cases, mean age 40.2±13.7, female 130 cases, mean age 39.0±12.7; 201 cases of Han Nationality, male 98 cases, mean age 39.2±12.6;female 103 cases, mean age 38.7±11.8, all the patients have lived in Ningxia at least 20 years, and the lateral radiographs of the cervical spine were taken in a standardized manner with a 180cm film-to-tube distance. Take the lateral cervical X-ray, measurements of the sagittal developmental diameter(SDD)、vertebral body diameter(VB) and calculate the Torg Ratio (SDD/VB), then grouped by if they are cervical spondylosis, compare the morphology of the cervical spinal canal of Hui nationality with Han nationality. Results The average of SDD in males and females of Hui Nationality are: C3: 17.24mm and 16.49mm; C4: 16.11mm and 15.48mm; C5: 16.29mm and 15.64mm; C6: 16.67mm and 15.67mm; C7: 16.37mm and 15.58mm; The average of SDD in males and females of Han Nationality are: C3: 16.42mm and 15.41mm; C4: 15.54mm and 14.70mm; C5: 15.85mm and 14.91mm; C6: 16.03mm and 15.02mm; C7: 16.00mm and 15.34mm, The largest SDD is C3 in both Hui and Han Nationality and males and females, C4 is the smallest. The average of VB in males and females of Hui Nationality are: V3: 17.67mm and 16.18mm; V4: 17.51mm and 16.06mm; V5: 17.42mm and 16.04mm; V6: 18.25mm and 16.87mm; V7: 19.12mm and 17.58mm; The average of VB in males and females of Han Nationality are: V3: 17.67mm and 16.21mm; V4: 17.63mm and 16.04mm; V5: 17.61mm and 15.96mm; V6: 18.21mm and 16.77mm; V7: 19.25mm and 17.05mm; The average of Torg Ratio in males and females of Hui Nationality are: C3: 0.98 and 1.03; C4: 0.93 and 0.97; C5: 0.94 and 0.98; C6: 0.92 and 0.93; C7: 0.86 and 0.90; The average of Torg Ratio in males and females of Hui Nationality are: C3: 0.94 and 0.96; C4: 0.89 and 0.92; C5: 0.91 and 0.94; C6: 0.89 and 0.90; C7: 0.84 and 0.90; SDD and VB in males are significantly lager than those in females.(P=0.00),Torg Ratio in females is significantly larger than that in males.(P≤0.01). Except the C6 level, SDD and VB in Hui Nationality are larger than those in Han Nationality. Conclusion The morphology of the cervical spinal canal of Hui Nationality in Ningxia is different from that of the Han Nationality besides gender differences.The SDD、Torg Ratio in cervical spondylosis group are significantly smaller than those in the nonspondylosis group.
引文
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[3] Murata Y,Onda A ,Rydevik B ,et al . Dist ribution and appearance of tumor necrosis factor alpha in the dorsal root ganglion exposed to experimental disc herniation in rat [J ] . Spine ,2004 ,29 :223522241.
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[5]李英平,郭瑞方.神经根型颈椎病解剖因素探讨[J ] .解剖科学进展,2003, 9 (2):1412143.
[6]廖俊星,周良安.颈型颈椎病的诊断与治疗.新医学,1997 ,28 (5) :232.
[7] Emery SE1Cervical spondylotic myelopathy :Diagnosis and treatment [J ]1Am Acad Orthop Surg ,2001 ,9(6) :37623881
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[12]朱桂忠,尹成方,路学美,等.数字化与普通X线钡餐检查对诊断食管型颈椎病的对比研究[J ] .实用医学影像杂志,2006 ,7 (1) :16-18.
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[15] Lin RM , Tsai KH ,et.al. characteristim of sagittal verterbral alignment in flexior determine by dynamic radiography of the cervical .spine.Spine.2001.26:256-261.
[16] Epstein JA, Carras R, Hyman RA, Costa S. Cervical myelopathy caused by developmental stenosis of the spinal canal. J Neurosurg.1979;51:362–7.
[17] Payne EE, Spillane JD. The cervical spine: an anatomico-pathological study of 70 specimens (using a special technique) with particular reference to the problem of cervical spondylosis. Brain 1957;80:571–96.
[18] Torg,JS,Pavlov H ,Genuario SE,el al,Neuropraxia of the cervical spinal,cord with transient quadriplegia. J Bone Joint ,Surg(Am), 1986,68:1354-1370.
[19] Herzog RJ, Wiens JJ, Dillingham MF, et al. Normal cervical spine morphometry and cervical spinal stenosis in asymptomatic professional football players. Spine 1991; 16 (suppl):178–86.
[20] Lee MJ,Gassinelli EH,Riew KD, et al .Prevalence of cervical spine stenosis. Anatomic study in cadavers. J Bone Joint Surg Am. 2007 Feb;89(2):376-80.
[21] Lim JK ,Wong HK. Variation of the cervical spinal Torg ratio with gender and ethnicity. spine J 2004 Jul-Aug;4(4):396-401.
[22] Yue WM,Tan SB,Tan MH,et al. The Torg--Pavlov ratio in cervical spondylotic myelopathy: a comparative study between patients with cervical spondylotic myelopathy and a nonspondylotic, nonmyelopathic population. 2001 Aug 15; 26 (16): 1760-4.
[23] Zhang L,Ying M,Dang GT,Wang C,et al. X-ray measurement of cervicalspinal canal in patients with degenerative lumbar spinal canal stenosis .Zhonghua Yi Xue Za Zhi .2006 Dec 5;86(45):319.
[24] Jit-Kheng Lim, Hee-Kit Wong,et al. Variation of the cervical spinal Torg ratio with gender and ethnicity. Spine J. 2004 Jul-Aug;4(4):396-401
[25] Gupta SK, Roy RC,et al.Sagittal diameter of the cervical canal in normal Indian adults. Clin Radiol. 1982 Nov;33(6):681-5.
[26] Sasaki T, Kadoya S, et al.Roentgenological study of the sagittal diameter of the cervical spinal canal in normal adult Japanese. Neurol Med Chir (Tokyo). 1998 Feb; 38(2):83-8.
[27] Lee HM, Kim NH, et al.Mid-sagittal canal diameter and vertebral body/canal ratio of the cervical spine in Koreans. Yonsei Med J. 1994 Dec;35(4):446-52.
[28]Amonoo-Kuofi HS, et al.Transverse diameter of the lumbar spinal canal in normal adult Saudis. Acta Anat (Basel). 1990;137(2):124-8.
[2] Epstein JA, Carras R, Hyman RA, Costa S. Cervical myelopathy caused by developmental stenosis of the spinal canal. J Neurosurg.1979;51:362–7.
[3] Herzog RJ, Wiens JJ, Dillingham MF, et al. Normal cervical spine morphometry and cervical spinal stenosis in asymptomatic professional football players. Spine 1991; 16 (suppl):178–86.
[4] Torg,JS,Pavlov H ,Genuario SE,el al,Neuropraxia of the cervical spinal,cord with transient quadriplegia. J Bone Joint ,Surg(Am), 1986,68:1354-1370.
[5] Yue WM, Tan SB, Tan MH, Koh DC, Tan CT. The Torg–Pavlov ratio in cervical spondylotic myelopathy: a comparative study between patients with cervical spondylotic myelopathy and a nonspondylotic, nonmyelopathic population. Spine 2001;26:1760–4.
[6] Torg JS, Naranja RJJ, Palov H, Galinat BJ, Warren R, Stine RA. The relationship of developmental narrowing of the cervical spinal canal to reversible and irreversible injury of the cervical spinal cord in football players. J Bone Joint Surg Am 1996;78:1308–14.
[7] Wai-Mun Yue, MBBS,FRCS(Edin),Seamg-Beng Tan,et al.The Torg-Pavlov Ratio in cervical spondylotic myelopathy. Spine 2001;16:1760-1764.
[8] ZhuJian-min, JinZong-da. Measurement of cervical spinal canal ratio in normal people. Chin Radiol J.1994; 28 (5): 317-20.
[9] Amonoo-Kuofi HS, et al.Transverse diameter of the lumbar spinal canal in normal adult Saudis. Acta Anat (Basel). 1990;137(2):124-8.
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