颈椎病患者项韧带钙化与颈椎曲度的相关性分析  

Correlation Analysis between the Ossification of Nuchal Ligament and Cervical Curvature in Patients with Cervical Spondylosis

作　　者：邓真 王玉鹏 赵璐璐 王辉昊 商海滨[1] 廉由之 李国中 詹红生 DENG Zhen;WANG Yupeng;ZHAO Lulu;WANG Huihao;SHANG Haibin;LIAN Youzhi;LI Guozhong;ZHAN Hongsheng(Shanghai Baoshan Hosptial of Integrated Traditional Chinese and Western Medicine,Shanghai 201999,China;Zhan Hongsheng Studio of Academic Experience of Shanghai Famous Doctors in Traditional Chinese Medicine,Shanghai 201203,China;Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海市宝山区中西医结合医院/上海中医药大学附属宝山医院,上海201999 [2]詹红生上海市名中医工作室 [3]上海中医药大学附属曙光医院

出　　处：《中国中医骨伤科杂志》2023年第1期19-24,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：国家自然科学基金项目(81804114,81973871);上海市卫健委临床行业面上项目(202240188);上海市人才发展资金资助项目(2019101);上海市卫计委詹红生上海市名老中医学术经验研究工作室建设项目(SHGS-2017025,SZYMYGZS4013);上海市中医诊疗模式创新试点建设项目(ZY2018-2002-FWTX-6003);上海中医药大学后备卓越中医人才项目(30);上海高水平地方高校创新团队(慢性筋骨病损研究与转化)。

摘　　要：目的:探讨颈椎病患者中项韧带钙化与颈椎曲度间的相关性。方法:回顾性分析290例颈椎病患者临床和影像学资料,根据有无项韧带钙化分为2组,测量项韧带钙化的程度,比较2组患者性别、年龄、体重指数(BMI)、病程、颈椎曲度、椎间隙高度丢失评分、疼痛数字评分量表(NRS)、伴随症状之间的差异;根据C2~C7Cobb角将颈椎曲度分为前凸型、直型和后凸型3种。分析项韧带钙化及程度与上述因素之间的相关性,找出影响项韧带钙化的危险因素。结果:290例颈椎病患者中,项韧带钙化发生率为61.38%,男性发病率为女性的1.62倍,共229个颈椎节段发生了项韧带钙化,依次为C_(5/6)(39.3%)、C_(4/5)(38.0%)、C_(3/4)(15.3%)、C_(6/7)(5.7%)和C_(2)/3(1.7%)。项韧带钙化组患者的年龄、C_(2)~C_(7) Cobb角、Jackson应力曲线、椎间隙高度丢失评分与无项韧带钙化组比较,差异均有统计学意义(P<0.05)。项韧带钙化与直型颈椎曲度呈强正相关性,与年龄、性别、椎间隙高度丢失评分呈中度正相关性,与疼痛数字评分量表评分呈轻度正相关性,与后凸型颈椎呈轻度负相关性,项韧带钙化程度与各因素间无相关性。直型颈椎曲度是项韧带钙化最重要的危险因素,其次是椎间隙高度丢失,疼痛数字评分量表评分和年龄对项韧带钙化也有影响。结论:项韧带钙化与直型颈椎高度相关,但钙化程度与颈椎曲度类型无关,项韧带钙化的发生可预测患者存在椎间隙高度丢失相关性疾病和较重的疼痛程度。Objective:To investigate the correlation between the ossification of nuchal ligament(ONL) and different type of cervical curvature in patients with cervical spondylosis.Methods:The clinical and imaging data of 290 patients with cervical spondylosis were analyzed retrospectively.They were divided into two groups according to the presence or absence of ONL.The degree of ONL was measured.The differences between the two groups in gender, age, body mass index(BMI),course of disease, cervical curvature, intervertebral space height loss score, numerical rating scale(NRS) scores and accompanying symptoms were compared.The cervical curvature was divided into three types: lordosis types, straight types and kyphosis types according to the C_(2) to C_(7) Cobb angle.The correlation between ONL and the above factors was analyzed to find out the risk factors affecting ONL.Results:Among the 290 cases of cervical spondylosis, the incidence of ONL was 61.38%,and the incidence rate of male was 1.62 times higher than that of female.There were 229 ONL segments, which were C_(5/6)(39.3%),C_(4/5)(38%),C_(3/4)(15.3%),C6/7(5.7%) and C_(2/3)(1.7%) respectively.There were significant differences in age, C_(2) to C_(7) Cobb angle, Jackson stress curve and intervertebral space height loss score between the ONL group and non-ONL group(P<0.05).There was a strong positive correlation between ONL and straight cervical curvature, a moderate positive correlation with age and intervertebral space height loss, a slight positive correlation with NRS and a slight negative correlation with kyphosis curvature.The degree of ONL had no correlation with all factors.Straight cervical curvature was the most important risk factor for ONL,followed by the loss of intervertebral space height.NRS and age are also risk factors for ONL.Conclusion:ONL is highly related to straight cervical curvature, but the degree of calcification has no relationship with the type of cervical curvature.The occurrence of ONL can predict that patients have diseases related to interve

关 键 词：项韧带钙化 颈椎曲度 颈椎病 颈椎间盘退变 

分 类 号：R681.5[医药卫生—骨科学]