正常志愿者C4、C5椎体在颈椎屈伸运动过程中的相对位置特征  

Relative position characteristics of C4 and C5 vertebral bodies in normal volunteers during cervical flexion and extension

作　　者：高雅鹏 陆庭斌 GAO Ya-peng;LU Ting-bin(The First Department of Imaging Section,Shaanxi Kangfu Hospital,Xi'an 710065,Shaanxi,CHINA)

机构地区：[1]陕西省康复医院影像一科

出　　处：《海南医学》2020年第2期217-221,共5页Hainan Medical Journal

摘　　要：目的采用动态X线技术研究正常志愿者C4、C5椎体在颈椎屈伸运动过程中相对位置特征的改变情况。方法选取2017年1月至2019年1月间在陕西省康复医院体检且常规X线平片、病史和临床症状均没有颈椎病表征的志愿者198例,依据志愿者年龄将其分为两组,其中75例>40岁者作为罹患颈椎病高风险组,123例<40岁者作为低风险组,采用西门子数字胃肠X线机(JPN)对志愿者颈椎从屈位到伸位运动过程行逐帧录影。选取C4、C5椎体前缘与上缘交点作为兴趣点,对C4、C5椎体相对位置夹角进行计算。采用Matlab?2014B软件编程,使图像实现配准及自动获取椎体兴趣点。整幅图像左下角当做坐标原点,横轴x与纵轴y正方向分别为背侧与头侧,每个像素各占据一个坐标,读取兴趣点像素坐标,采用反正切函数,记录两组志愿者颈椎各阶段椎间活动度情况。结果两组志愿者C4和C5椎体位置夹角与颈椎的运动部位行曲线拟合,方程式如下:f(x)=pl×x7+p2×x6+p3×x5+p4×x4+p5×x3+p6×x2+p7×x+p8(e是10指数形式,括号内是最大、最小值,括号外平均数值,p1至p8是各项式系数);低风险组志愿者颈椎C5~6、C6~7椎间活动度分别为(20.08±3.93)°、(17.65±3.80)°,明显高于高风险组的(13.93±3.28)°、(10.34±3.22)°,差异均有统计学意义(P<0.05)。结论颈椎屈伸运动时伴随颈椎的整体运动,C4和C5椎体间相对位置会出现规律性改变,随着年龄的增加机体颈椎活动度会下降;颈椎动态X线能够很好地评估颈椎各阶段运动情况,对临床颈椎病患者的诊疗有重要指导价值。Objective To analyze the relative positional characteristics of C4 and C5 vertebral bodies in normal volunteers during cervical flexion and extension using dynamic X-ray technique. Methods A total of 198 volunteers who underwent physical examination in Shaanxi Kangfu Hospital from January 2017 to January 2019 and had no routine X-ray film, medical history and clinical symptoms. According to the age of the volunteers, they were divided into two groups: >40 years old as the high risk group of cervical spondylosis(high-risk group, 75 cases), and <40 years old as the low-risk group(123 cases). The Siemens digital gastrointestinal X-ray machine(JPN) was used to record the framed motion of the cervical spine from flexion to extension. The intersections of the leading edge and the upper edge of the C4 and C5 vertebral bodies were selected as the points of interest, and the relative positions of the C4 and C5 vertebral bodies were calculated. Programming with Matlab?2014 B software enables image registration and automatic acquisition of vertebral points of interest. The lower left corner of the whole image is used as the coordinate origin, and the positive direction of the horizontal axis x and the vertical axis y are the back side and the head side, respectively. Each pixel occupies one coordinate, and the pixel coordinates of the interest point are read. Using arctangent function, the degree of intervertebral activity in each stage of the cervical spine is recorded. Results The relative positions of C4 and C5 in the low-risk group were significantly changed during exercise. The angles between the C4 and C5 vertebral body positions of the two groups of volunteers were fitted with the curve of the cervical vertebrae. The equation is as follows: f(x)=pl×x7+p2×x6+p3×x5+p4×x4+p5×x3+p6×x2+ p7×x+p8(e is a 10-index form;in the parentheses are the maximum and minimum values;outside the parentheses are the average values;p1 to p8 are various coefficients). The cervical intervertebral activities of C5~6 and C6~7 in the low

关 键 词：颈椎退行性骨关节病 动态X线 颈椎相对位置 颈椎运动范围 曲线拟合 

分 类 号：R336[医药卫生—人体生理学]