颈椎曲度改变与胸椎侧凸的关系研究  

The relationships between cervical curvature change and thoracic scoliosis:a clinical study

作　　者：陈威烨 华永均 杨晴雨 陈金洪 朱利民 CHEN Weiye;HUA Yongjun;YANG Qingyu;CHEN Jinhong;ZHU Limin(Fuyang TCM Orthopedic-Traumatological Hospital,Hangzhou 311400,Zhejiang,China)

机构地区：[1]杭州市富阳中医骨伤医院,浙江杭州311400

出　　处：《中医正骨》2021年第12期11-13,26,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：浙江省中医药科技计划项目(2020ZQ048)。

摘　　要：目的:探讨颈椎曲度改变与胸椎侧凸的关系。方法:2020年3-12月招募30例颈椎病患者(颈椎病组)和30例健康志愿者(无颈椎病组)。所有受试者均拍摄颈、胸椎X线片,观察颈椎生理曲度和胸椎冠状位形态,测量颈椎曲线深度(cervical curve depth,CCD)和胸椎顶椎偏距(thoracic apical vertebral translation,T-AVT)。结果:颈椎病组30例均存在颈椎生理曲度改变和冠状位胸椎序列偏移,无颈椎病组3例存在颈椎生理曲度改变、24例存在冠状位胸椎序列偏移;颈椎病组颈椎生理曲度改变发生率和冠状位胸椎序列偏移发生率均高于非颈椎病组(χ^(2)=49.091,P=0.000;P=0.024)。颈椎病组的CCD小于无颈椎病组[(1.5±1.1)mm,(12.4±2.6)mm,t=2.362,P=0.025],T-AVT大于无颈椎病组[(8.2±3.7)mm,(4.1±1.8)mm,t=2.175,P=0.038]。Pearson相关分析显示,颈椎病组患者的CCD与T-AVT呈负相关(r=-0.541,P=0.043)。结论:颈椎生理曲度改变与胸椎侧凸有关,胸背部慢性劳损引起的颈、胸部生物力学失衡可能是颈椎病发病的重要原因之一。Objective:To explore the relationships between cervical curvature change and thoracic scoliosis.Methods:Thirty cervical spondylosis(CS)patients(CS group)and 30 healthy volunteers(non-CS group)were recruited from March 2020 to December 2020.The cervical and thoracic X-ray films were taken for all subjects.The cervical physiological curvature and coronal plane thoracic morphology were observd, and the cervical curve depth(CCD)and thoracic apical vertebral translation(T-AVT)were measured on the X-ray films.Results:Thirty patients suffered from both cervical physiological curvature change and coronal thoracic sequence deviation in CS group, while cervical physiological curvature change was found in 3 persons and coronal thoracic sequence deviation was found in 24 ones in non-CS group.The incidence rates of cervical physiological curvature change and coronal thoracic sequence deviation were higher in CS group compared to non-CS group(χ^(2)=49.091,P=0.000;P=0.024).The CCD was smaller, whereas the T-AVT was greater in CS group compared to non-CS group(1.5±1.1 vs 12.4±2.6 mm, t=2.362,P=0.025;8.2±3.7 vs 4.1±1.8 mm, t=2.175,P=0.038).The results of Pearson correlation analysis showed that CCD was negatively correlated with T-AVT in CS group(r=-0.541,P=0.043).Conclusion:The changes in physiological curvature of cervical spine is related to thoracic scoliosis, and the cervico-thoracic biomechanical imbalance caused by thoracodorsal chronic strain may be one of the important reasons for cervical spondylosis.

关 键 词：颈椎病 脊柱侧凸 胸椎 相关分析 

分 类 号：R681.55[医药卫生—骨科学]