颈椎生理曲度改变与寰枢关节失稳的相关性分析  

Correlative analysis of cervical curvature and atlantoaxial instability

作　　者：朱永涛 吕立江[1] 张潮 黄玉波 吴虹娇 黄华枝 刘祯 ZHU Yong-tao;LYU Li-jiang;ZHANG Chao;HUANG Yu-bo;WU Hong-jiao;HUANG Hua-zhi;LIU Zhen(The Third Clinical Medical College of Zhejiang Traditional Chinese Medicine University,Hangzhou310053,Zhejiang,China)

机构地区：[1]浙江中医药大学第三临床医学院,浙江杭州310053

出　　处：《中国骨伤》2022年第2期132-135,共4页China Journal of Orthopaedics and Traumatology

基　　金：国家自然科学基金项目(编号:81774442);国家临床重点专科建设项目(编号:2013-42);浙江省重大疾病中医药防治中心项目(编号:2018-9);浙江省中医药科技计划项目(编号:2019-52)。

摘　　要：目的:探讨颈椎生理曲度改变与寰枢关节失稳的相关性。方法:自2018年1月至2019年12月,采用回顾性分析方法对50例门诊就诊的颈椎曲度异常的患者(颈曲异常组)进行颈椎生理曲度改变与寰枢关节失稳的相关性研究,其中男24例,女26例,年龄18~42(30.62±5.83)岁;匹配同期门诊就诊的颈椎曲度正常的患者(颈曲正常组)53例,其中男23例,女30例,年龄21~44(31.98±6.11)岁。103例患者均拍摄颈椎侧位和张口位X线片,测量并记录颈椎曲度和寰齿侧间距差值,采用Pearson相关系数分析法研究颈椎生理曲度改变与寰枢关节失稳的相关性。结果:颈曲正常组中寰枢关节失稳者占39.6%(21/53),颈曲异常组患者中寰枢关节失稳占84.0%(42/50),两组差异有统计学意义(P<0.01)。颈曲异常组的患者寰齿侧间距差值为(1.79±1.01)mm,明显大于颈曲正常组的(0.55±0.75)mm(P<0.01),经Pearson相关系数分析,颈椎曲度的大小与寰齿侧间距的差值呈负相关。结论:颈椎曲度变直和反弓是寰枢关节失稳的原因,颈椎曲度越小,寰枢关节失稳越严重。Objective:To investigate the correlation between the changes of cervical curvature and atlantoaxial instability.Methods:The correlation between the changes of cervical curvature and atlantoaxial instability was retrospectively studied in 50 outpatients with abnormal cervical curvature(abnormal cervical curvature group)from January 2018 to December 2019.There were 24 males and 26 females in abnormal cervical curvature group,aged from 18 to 42 years old with an average of(30.62±5.83)years.And 53 patients with normal cervical curvature(normal cervical curvature group)during the same period were matched,including 23 males and 30 females,aged from 21 to 44 years with an average of(31.98±6.11)years.Cervical spine X-ray films of 103 patients were taken in lateral position and open mouth position.Cervical curvature and variance of bilateral lateral atlanto-dental space(VBLADS)were measured and recorded,Pearson correlation coefficient analysis was used to study the correlation between the changes of cervical curvature and atlantoaxial instability.Results:Atlantoaxial joint instability accounted for 39.6%(21/53)in normal cervical curvature group and 84.0%(42/50)in abnormal cervical curvature group.There was significant difference between two groups(P<0.01).VBLADS in abnormal cervical curvature group was(1.79±1.01)mm,which was significantly higher than that in normal cervical curvature group(0.55±0.75)mm(P<0.01).Pearson correlation coefficient analysis showed that the size of cervical curvature was negatively correlated with VBLADS.Conclusion:Cervical curvature straightening and inverse arch are the cause of atlantoaxial instability,the smaller the cervical curvature,the more serious the atlantoaxial instability.

关 键 词：寰枢关节 关节不稳定性 颈椎曲度 

分 类 号：R684.7[医药卫生—骨科学]