大骨节病对下颈椎椎间隙高度及形态的影响  

Effect of Kashin-Beck Disease on the Height and Morphology of Lower Cervical Intervertebral Space

作　　者：吴学元[1] 易智[1] 马宏伟 凌鸣[1] 靳占奎[1] 孙正明[1] Wu Xueyuan;Yi Zhi;Ma Hongwei;Ling Ming;Jin Zhankui;Sun Zhengming(Department of Orthopedics,People’s Hospital of Shanxi,Xi'an 710068,China;Department of Orthopedics,the Second People’s Hospital of Ning Xian,Qing Yang 745201,China)

机构地区：[1]陕西省人民医院骨科,陕西西安710068 [2]宁县第二人民医院骨一科,甘肃庆阳745201

出　　处：《实用骨科杂志》2022年第8期673-678,共6页Journal of Practical Orthopaedics

基　　金：陕西省自然科学基础研究计划项目(2019JM-517);陕西省人民医院科技发展孵化基金(2019YXQ-10);陕西省重点研发计划项目(2018ZDXM-SF-054)。

摘　　要：目的通过测量中老年大骨节病(Kashin-Beck disease,KBD)患者下颈椎椎间隙高度,观察椎间隙的影像学形态,明确大骨节病对下颈椎椎间隙高度及形态的影响。方法纳入2019年8月至2019年12月在甘肃宁县第二人民医院检查的KBD患者(KBD组)92例,其中男38例,女54例;年龄47~70岁,平均(58.89±7.67)岁,以及非KBD人群(对照组)98例,其中男42例,女56例;年龄49~69岁,平均(58.35±7.38)岁。两组人群行颈椎侧位X线片检查,观察下颈椎间隙影像学表现;测量两组C_(2~7)椎间隙前缘、中间及后缘高度,并进行统计学分析。结果结果显示KBD组男、女C_(4~7)椎间隙中间高度均低于C_(2~4),差异有统计学意义(P<0.05)。KBD组男、女C_(2~4)椎间隙中间高度低于对照组,但差异无统计学意义(P>0.05),而C_(4~7)椎间隙中间高度均低于对照组,差异有统计学意义(P<0.05)。KBD组男、女患者C_(2~4)椎间隙中间高度相比,差异有统计学意义(P<0.05),而两性别C_(4~7)椎间隙中间高度相比,差异无统计学意义(P>0.05)。根据椎间隙的高度及形态X线表现,可分为间隙正常型27例(29.35%)、增宽型11例(11.96%)、狭窄型42例(45.65%)及椭圆型12例(13.04%)。其特征性改变为部分椎体终板上下面凹陷、凹凸不平、硬化。结论KBD并不影响颈椎间盘发育,但KBD患者更倾向于发生椎间盘退变,高度丢失。本研究初步证实KBD与颈椎椎间盘退变发生可能具有一定相关性。Objective To measure the height of cervical intervertebral space and observe the imaging morphology in elderly patients with Kashin-Beck disease(KBD)to clarify the influence of KBD on the lower cervical vertebrae.MethodsFrom Aug 2019to Dec 2019,atotal of 92patients with KBD(38men and 54women)with an average age of(58.89±7.67)years(range:47~70years)and 98healthy subjects(42men and 56women)with an average age of(58.35±7.38)years(range:49~69years)were enrolled and examed at the Second People’s Hospital of Ning Xian.The KBD patients(KBD group)and the healthy subjects(control group)were taken with lateral cervical radiographs to observe the imaging manifestations of the lower cervical intervertebral space.The anterior,middle and posterior heights of the intervertebral space from C_(2~7)in neutral position were measured and statistical analysis was performed.Results The results of this study showed that the middle heights of C_(4~7)in male and female in KBD group were lower than that of C_(2~4),with significant statistical difference(P<0.05).The middle heights of C_(2~4)in both male and female in KBD group were lower than those in the control group,but with no statistical significance(P>0.05).The middle heights of C_(4~7)in both male and female in KBD group were lower than those of control group(P<0.05).There were statistically significant differences in the middle height of C_(2~4)between male and female patients in KBD group(P<0.05),and there was no significant difference in the middle heights of C_(4~7) between the two genders(P>0.05).The X-ray examination showed that imaging morphologies of lower cervical intervertebral space were divided into normal intervertebral height in 27cases(29.35%),widened height in 11cases(11.96%),narrow height in 42cases(45.65%)and elliptical space in 12cases(13.04%)based on the height and shape of the intervertebral space.The characteristic changes of endplate were depression,uneven or sclerosis.Conclusion The KBD does not affect the development of cervical intervertebral disc,while

关 键 词：大骨节病 椎间高度 终板 下颈椎 影像学形态 

分 类 号：R684.1[医药卫生—骨科学]