颈椎过屈过伸X线检查在颈椎病诊断中的应用  

X-ray diagnosis of cervical spondylosis by flexion-extension position

作　　者：李振平[1] 焦海霞[1] 杨彩琴[1] 张伟[1] 

机构地区：[1]河南省三门峡市中心医院,河南三门峡472000

出　　处：《医学影像学杂志》2006年第9期957-959,共3页Journal of Medical Imaging

摘　　要：目的：探讨过屈过伸功能位摄片在颈椎病X线诊断中的应用价值。方法：对200例颈椎病患者进行过屈及过伸颈椎侧位片检查，测量其前屈角、后伸角及相对角，观察颈椎向前及／或向后滑移情况和棘突分离或相互靠近情况。结果：前屈角为82°～156°，平均128°。后伸角为45°-89°，平均64°。相对角36°～96°，平均65°。过屈位颈椎椎体前移者138例，后移者9例，部分椎体前移部分椎体后移者2例；过伸位颈椎椎体后移者154例；颈椎不稳主要发生在C2～C3和C3-C4；过屈位局部棘突不能分离者28例，过伸位局部棘突不能靠近者83例。结论：过屈过伸功能位能发现常规颈椎正侧斜位片未能显示的颈椎失稳和功能改变；有时还能发现常规片中未能显示或显示不清楚的解剖结构性改变；对X线观察颈椎运动，记录局部韧带损害，颈椎失稳及用以估计治疗后功能恢复的程度有重要作用。Objective：To evaluate the value of flexion-extemion radiography in the diagnosis of cervical spondylosis. Methods：Over flexion-extension cervical spine radiography was performed on 200 patients with cervical spondylosis. The flexion, extension, and relative angles were measured on these films. The gliding of each verterbral body forward and/or backward, and the separation or close approximation of the spinous processes were also evaluated, Results：The range of the flexion angles was 82 to 156 degrees（average 128 degrees）, the extension angles 45 to 89 degrees（an average of 64 degrees） and the relative angles 36 to 96degrees（65 degrees on average）. 138 patients showed the gliding of the vertebral bodies forward ,9 backward , and 2 had both anterio-and posterior displacement seen on the flexion radiographs. 154 patients showed the vertebral bodies gliding posterioly seen on the extension radiographs. Cervical instability mainly occurred at C2 - C3 and C3 - C4. 28 patients failed to show the separation of the regional spinous processes on the flexion films, while 83 patients could not revealed the close approximation of the spinous processes on the extension films. Conclusion： The flexion-extension studies may reveal not only the cervical instability, the limiation of cervical movement but sometime even the anatomical structural changes not seen on the conventional cervical spine radiographs . It plays an important role not only in the observation of the cervical movement , the segmental ligamentous damage and the cervical instability, but also in the evaluation of the functional improvement upon later reexamination after the therapeutic measures.

关 键 词：颈椎病 过屈过伸位 X线检查 诊断 

分 类 号：R681.55[医药卫生—骨科学] R814.41[医药卫生—外科学]