颈椎间盘突出程度与颈椎X线片相关指标测量值的相关性研究  

The correlation analysis of the degree of cervical intervertebral disc herniation associated with cervical X-ray radiography index

作　　者：蒋维利[1] 申才良[1] 董福龙[1] 章仁杰[1] 汪军[2] 朱晓红[2] 张华庆[1] 

机构地区：[1]合肥安徽医科大学第一附属医院脊柱外科,230022 [2]合肥安徽医科大学第一附属医院放射科,230022

出　　处：《中华解剖与临床杂志》2015年第2期112-117,共6页Chinese Journal of Anatomy and Clinics

摘　　要：目的探讨单节段脊髓型颈椎病患者颈椎X线片相关指标与椎间盘突出导致的颈脊髓压迫严重程度的相关性。方法回顾性分析2012年8月—2014年3月安徽医科大学第一附属医院脊柱外科诊治的60例单节段脊髓型颈椎病患者的临床资料,均为男性,年龄42~65岁,平均（54.8依9.3）岁。在颈椎MRI矢状位成像上按照颈脊髓受压的比例（ E值）分为Ⅰ组、Ⅱ组及Ⅲ组。在颈椎MRI横断面成像上测量并计算颈髓横切面积（ S1）与有效椎管横切面积（ S0）的比值,以此判断椎间盘突出程度；在不同体位颈椎X线摄片上测量责任椎间隙的活动度值（B值）、椎间隙前缘高度（ D值）、颈椎C2~7 Cobb角及椎间孔面积（ M值）等相关指标。采用直线相关回归分析颈椎间盘突出程度与各观测指标之间的相关性。结果3组间S1/S0值、E值、B值、D值、C2~7 Cobb角和M值差异均有统计学意义（F值分别为44.187、112.789、7.232、3.778、3.232、15.813,P值均〈0.05）。随着S1/S0值的增加,E值、B值、D值、C2~7 Cobb角和M值均逐渐减小,提示责任椎间隙E值、B值、D值、C2~7 Cobb角、M 值与 S1/S0值均呈负相关性（ R 值分别为-0.821、-0.581、-0.378、-0.419、-0.576,P值均〈0.05）。经多元线性回归分析,B 值、D 值、M 值是 S1/S0的3个独立影响因素, S1/S0值的预测方程为^Y=118.955-1.348X1-2.850X2-0.541X3（复相关系数R=0.742,决定系数R2=0.550,F=22.841,P〈0.01）,回归模型有统计学意义。结论不同体位颈椎X线摄片的相关指标B值、D值、M值是影响脊髓型颈椎病椎间盘退变突出程度的独立因素,对评估单节段脊髓型颈椎间盘突出的严重程度有一定的诊断价值；采用D值、B值及M值为3个自变量指标,可对椎间盘突出进行预测。Objective To investigate the relationship of the related parameters of X-ray and the severity of cervical spinal cord compression caused by disc herniation in patients with single segment spondylotic myelopathy. Methods Clinical data of sixty paitents with single segment spondylotic myelopathy in the First Affiliated Hospital of Anhui Medical University from August 2012 to March 2014 were retrospectively analyzed. All the patients, aged from 42 to 65 （58. 4±9. 3）, were male. According to the compression ratio （ E value） of cervical spinal cord in sagittal MRI images, all the patients were firstly divided into group Ⅰ, II and Ⅲ. The ratio of cervical spinal crosscutting area （ S1 ） to effective cervical canal crosscutting area （ S0 ） in cross-sectional imagings of cervical spine MRI was then calculated to reflect the degree of intervertebral disc herniation. Furthermore, the following indicators in cervical X-ray in different postures were measured for each case： the range of motion of the responsibility of intervertebral space （ B value） , the height of the anterior of intervertebral space （ D value） , Cobb angle of C2-7 , and the area of intervertebral foramen （ M value） . Linear correlation regression was used to study the relationship of the severity of cervical spinal cord compression and the above observation indexes. Results There were significant differences in the ratio of S1/S0 , E value, B value, D value, M value and Cobb angle of C2-7 among three groups （F values were 44. 187, 112. 789, 7. 232, 3. 778, 3. 232 and 15. 813, respectively. all P values〈0. 05）. E value, B value, D value, M value and Cobb angle of C2-7 decreased with the increase＆nbsp;of the ratio of S1/S0 . These indicated that E value, B value, D value, M value and Cobb angle of C2-7 were negatively correlated with the ratio of S1/ S0 （ R values were-0. 821, -0. 581, -0. 378, -0. 419 and-0. 576, respectively, all P values〈0. 05）. The multiple linear regression results showed that B value, D

关 键 词：颈椎病 椎间盘移位 体层摄影术 X线 

分 类 号：R681.5[医药卫生—骨科学] R816.8[医药卫生—外科学]