不同年龄颈椎病患者颈椎椎间盘退行性变与颈椎矢状位参数之间的关系  

Relationship between cervical disc degeneration and cervical sagittal parameters in cervical spondylosis patients with different ages

作　　者：刘承鑫 李翔宇 王宇 郭澍溟 鲁世保[1] Liu Chengxin;Li Xiangyu;Wang Yu;Guo Shuming;Lu Shibao(Department of Orthopaedics,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院骨科,北京100053

出　　处：《脊柱外科杂志》2022年第2期116-120,共5页Journal of Spinal Surgery

摘　　要：目的探讨不同年龄颈椎病患者颈椎椎间盘退行性变与颈椎矢状位参数之间的关系。方法选择2018年1月—2019年5月收治的102例颈椎病患者作为研究对象。采用改良Pfirrmann分级评价颈椎椎间盘退行性变情况,将患者分为严重退行性变组和非严重退行性变组。在颈椎侧位X线片上测量C_(2)~T_(1)各节段椎间角度和椎间盘高度、C_(2~7)前凸角、C_(2~7)矢状面轴向距离(SVA)、C_(7)倾斜角。分析不同年龄患者(≥65岁和<65岁)颈椎退行性变程度与颈椎矢状位参数之间的关系。结果所有患者C_(5)/C_(6)椎间角度与椎间盘高度正相关(r=0.290)、与改良Pfirrmann分级负相关(r=-0.236)。在62例非老年患者(<65岁)中,严重退行性变组(10例)的C_(2~7)前凸角比非严重退行性变组(52例)小,差异有统计学意义(P<0.05)。在40例老年患者(≥65岁)中,严重退行性变组(11例)的C_(2~7)前凸角与非严重退行性变组(29例)相比,差异无统计学意义(P>0.05)。老年患者的C_(2~7)前凸角和C_(7)倾斜角均大于非老年患者,差异有统计学意义(P<0.05),且C_(2~7)前凸角与C_(7)倾斜角正相关(r=0.525)。老年患者与非老年患者的SVA差异无统计学意义(P>0.05)。结论颈椎病患者的C_(2~7)前凸角及C_(7)倾斜角随着年龄的增加而增大。在非老年患者中,严重的颈椎椎间盘退行性变会导致C_(2~7)前凸角减小;在老年患者中,颈椎椎间盘退行性变程度与C_(2~7)前凸角无关。Objective To explore the relationship between cervical disc degeneration and cervical sagittal parameters in cervical spondylosis patients at different ages.Methods A total of 102 patients with cervical spondylosis treated from January 2018 to May 2019 were selected as the research objects.The modified Pfirrmann grading was used to evaluate the degeneration of cervical discs.According to the modified Pfirrmann grading,the patients were divided into severe degeneration group and non-severe degeneration group.The intervertebral angle and disc height of each cervical segment(C_(2)-T_(1)),C_(2-7)lordosis,C_(2-7)sagittal vertical axis(SVA),C_(7)slope were measured on the cervical lateral roentgenograph.The relationship between cervical disc degeneration and cervical sagittal parameters in patients at different ages(≥65 years old and<65 years old)were analyzed.Results At C_(5)/C_(6) of all the 102 patients,intervertebral angle was positively correlated with disc height(r=0.290)and negatively correlated with modified Pfirrmann grading(r=-0.236).In 62 non-elderly patients(<65 years old),the C_(2-7)lordosis in the severe degenerative group(n=10)was smaller than that in the non-severe degenerative group(n=52),and the difference was statistically significant P<0.05).In 40 elderly patients(≥65 years old),there was no significant difference in C_(2-7)lordosis between the severe degenerative group(n=11)and non-severe degenerative group(n=29,P>0.05).Elderly patients had greater C_(2-7)lordosis and C_(7)slope than non-elderly patients(P<0.05),and there was a significant correlation between C_(2-7)lordosis and C_(7)slope(r=0.525).There was no significant difference in SVA between the elderly patients and non-elderly patients(P>0.05).Conclusion In the patients with cervical spondylosis,C_(2-7)lordosis and C_(7)slope would increase with the age.In the non-elderly patients,the degeneration of cervical discs would lead to a reduction of C_(2-7)lordosis;however,in elderly patients,C_(2-7)lordosis wouldn’t significantly change wi

关 键 词：颈椎 颈椎病 摄影测量法 

分 类 号：R681.531[医药卫生—骨科学]