健康成人与颈5/6单节段脊髓型颈椎病患者颈椎MRI矢状面形态的比较  

Analysis of cervical sagittal alignments in MRIs between normal adults and patients with C_(5/6) single-level degenerative cervical myelopathy

作　　者：蔡大钊 王子豪 马一鸣 鹿麒 吴东迎 袁峰 陈宏亮 Cai Dazhao;Wang Zihao;Ma Yiming;Lu Qi;Wu Dongying;Yuan Feng;Chen Hongliang(Department of Spine Surgery,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China)

机构地区：[1]徐州医科大学附属医院脊柱外科,徐州221006

出　　处：《中华解剖与临床杂志》2022年第11期763-768,共6页Chinese Journal of Anatomy and Clinics

基　　金：中国博士后科学基金(2017M621826)。

摘　　要：目的探讨健康成人和C_(5/6)单节段脊髓型颈椎病(DCM)患者颈椎MRI矢状面形态的差异及与DCM的相关性。方法回顾性研究。纳入2021年1—11月徐州医科大学附属医院脊柱外科门诊143例C_(5/6)单节段DCM患者(DCM组)及144例健康体检成人(对照组)的MRI影像资料。其中,DCM组男72例、女71例,年龄30~70(56.7±11.0)岁。对照组男72例、女72例,年龄30~70(55.8±9.4)岁。在颈椎MRI矢状面测量C2斜率(C2S)、颈前凸角(CL)、C2~7矢状位轴向距离(cSVA)、T1倾斜角(T1S)、颈倾斜角(NT)、胸廓入口角(TIA)、脊柱-颅角(SCA)、颈椎倾斜(CeT)和颅倾斜(CrT)。分别在对照组、DCM组内对比不同性别间及两组间各项影像学参数的差异;在DCM组观察各影像学参数与单节段DCM发病的相关性。结果对照组中,女性C2S(11.25°±6.51°)大于男性(7.63°±7.82°),CL(8.12°±8.45°)、T1S(20.89°±6.50°)、TIA(71.72°±11.88°)、SCA(86.44°±8.54°)、CeT(16.20°±6.59°)均低于男性(14.69°±9.77°、23.27°±7.65°、75.50°±10.92°、95.89°±10.56°、19.23°±8.34°),差异均有统计学意义(P值均<0.05);cSVA、NT、CrT在不同性别间比较,差异均无统计学意义(P值均>0.05)。DCM组中,女性SCA(88.19°±11.78°)、CeT(15.11°±8.46°)低于男性(95.88°±11.84°、18.10°±9.21°),而CrT(5.09°±4.22°)高于男性(3.82°±3.20°),差异有统计学意义(P值均<0.05);其他观察指标在不同性别间差异均无统计学意义(P值均>0.05)。对照组与DCM组:女性间比较,对照组NT(50.83°±12.66°)、TIA(71.72°±11.88°)均低于DCM组(55.81°±13.15°、76.02°±13.45°),差异均有统计学意义(P值均<0.05);男性间比较,对照组CL(14.68°±9.67°)高于DCM组(10.37°±13.78°),NT(52.24°±8.89°)、TIA(75.50°±10.92°)低于DCM组(57.33°±11.18°、79.27°±9.40°),差异均有统计学意义(P值均<0.05)。男性、女性C_(5/6)单节段DCM发病均与CL和NT相关(DCM女性组r=-0.26、0.28,DCM男性组r=-0.22、0.25,P值均<0.05)。结论健Objective This study aimed to compare the differences and correlation of cervical sagittal alignment between healthy adults and patients with C_(5/6) single-level degenerative cervical myelopathy(DCM)based on gender.Methods In this retrospective study,143 patients with C_(5/6) single-level DCM(DCM group)and 144 normal adults(control group)in the spinal surgery department of the Affiliated Hospital of Xuzhou Medical University from January to November 2021 were included.In the DCM group,72 were males and 71 were females,aged between 30 and 70(56.7±11.0)years.In the control group,72 were males and 72 were females,aged between 30 and 70(55.8±9.4)years.The following parameters were measured and recorded on sagittal MRI of the cervical spine:C2 slope(C2S),cervical lordosis(CL),C2-7 sagittal vertical axis(cSVA),T1 slope(T1S),neck tilt(NT),thoracic inlet angle(TIA),spinocranial angle(SCA),cervical tilt(CeT),cranial tilt(CrT),and range of compressed spinal cord of patients with DCM.The differences in imaging parameters between males and females were analyzed in both groups,and the parameters of both genders were separately compared between the two groups.The correlation between spinal cord compression range and all imaging parameters was compared in male and female DCM group.Results In the control group,C2S was higher in females(11.25°±6.51°)than in males(7.63°±7.82°),whereas CL(8.12°±8.45°),T1S(20.89°±6.50°),TIA(71.72°±11.88°),SCA(86.44°±8.54°)and CeT(16.20°±6.59°)were all lower in females than in males(14.69°±9.77°,23.27°±7.65°,75.50°±10.92°,95.89°±10.56°,and 19.23°±8.34°),and the difference was statistically significant(all P values<0.05).No significant difference was found in the cSVA,NT,and CrT between males and females(all P values>0.05).In the DCM group,SCA(88.19°±11.78°)and CeT(15.11°±8.46°)were lower in females than in males(95.88°±11.84°and 18.10°±9.21°),while the CrT(5.09°±4.22°)in females was higher than that in males(3.82°±3.20°),and the difference was

关 键 词：颈椎病 磁共振成像 性别因素 颈椎矢状面形态 

分 类 号：R681.55[医药卫生—骨科学]