X线侧位片头颅姿势与颈椎曲度分型及平衡的相关性研究  

Correlation analysis between position of head,cervical curvature classification and balance of cervical spine through lateral plain radiograph measurement

作　　者：王宽[1] 邓真[1] 王辉昊[1] 李正言[1] 牛文鑫[2] 陈博[1] 张明才[1] 元唯安[1] 詹红生[1] 

机构地区：[1]上海中医药大学附属曙光医院石氏伤科医学中心上海市中医药研究院骨伤科研究所,上海201203 [2]同济大学医学院上海市养志康复医院上海市阳光康复中心,上海201619

出　　处：《中国骨伤》2017年第5期458-462,共5页China Journal of Orthopaedics and Traumatology

基　　金：国家自然科学基金项目(编号:81473702;81503596;81202707;81001528;81503596)~~

摘　　要：目的:分析自然平视状态下头颅姿势的差异与颈椎曲度分型及相关颈椎力学平衡参数间的关系。方法 :调阅2015年1月至12月于骨伤科就诊、符合纳排标准的60例颈椎病患者颈椎X线侧位片,其中男22例,女38例,平均年龄(35.5±10.9)岁。进行颈椎曲度分型,测量McGregor倾角、C_2下终板倾角、T_1倾角、头颅重心至C_7的矢状垂直偏距(CG-C_7SVA)、C_2椎体中心至C_7的矢状垂直偏距(C_2-C_7SVA),使用Spearman法分析其相关性。结果 :颈椎曲度分型与C_2下终板倾角、C_0-C_2夹角(C_2下终板倾角与McGregor倾角的和)、CG-C_7SVA、T_1倾角的相关性存在统计学差异(P<0.05),但曲度分型与McGregor倾角无关(P>0.05)。另外CG-C_7SVA与C_2下终板倾角(r=0.77)、C_2-C_7SVA(r=0.87)呈一定程度正相关(P<0.05)。结论:头颅在自然平视状态下的姿势与颈椎曲度一定程度上相关,头颅重心随着仰头向后移动,后移仰头者提示其可能伴有相对正常的生理曲度。部分曲度异常的患者在自然状态下表现出轻微低头的姿势,对于该类人群进行姿势、锻炼的健康宣教对恢复其颈部的平衡关系有一定的意义。Objective： To analyze the relationship between position of head,cervical curvature type and associated cervical balance parameters in a neutral looking-forward posture.Methods： Cervical lateral X-rays of 60 patients with cervical spondylosis were selected from January to December 2015. There were 22 males and 38 females with an average age of （35.5±10.9） years old. The measured parameters included cervical curvature type,McGregor slope,C2 lower end plate slope,T1 slope,center of gravity to C7 sagittal vertical offset （CG-C7 SVA）,and C2 to C7 sagittal vertical offset （C2-C7 SVA）. The parameters were analyzed using Spearman correlation.Results： The cervical curvature type was significantly correlated with C2 lower endplate slope,C0-C2 angle （total degree of C2 lower endplate slope plus McGregor slope）,CG-C7 SVA and T1 slope （P〈0.05）,but it was not significantly correlated McGregor slope （P〉0.05）. C2 lower endplate slope and C2-C7 SVA （r=0.87） were significantly （P〈0.05） correlated with CG-C7 SVA （P〈0.05）.Conclusion： There was certain some relationship among position of head,cervical curvature type and associated cervical balance parameters in a neutral looking-forward posture. The center of gravity of the head would backwards shift following faced upward. A position of extension with posterior-shifting of the head would suggest that it may be accompanied with a relatively normal lordosis of the cervical spine. Some patients with abnormal curvature showed slightly bended head in the natural posture. Health education toward these people would be meaningful to restore the balance of their neck.

关 键 词：颈椎曲度 生物力学 影像学测量 

分 类 号：R681.55[医药卫生—骨科学]