退行性颈椎病矢状位曲度参数与颈肩部肌肉痛阈的相关性  

Correlation between sagittal curvature parameters and pain threshold for neck-shoulder muscles in degenerative cervical spondylosis

作　　者：杨云霄 黄承兰 侯俞彤 姚远 赵宇 许苑晶 杨泽政 王金武[6] Yang Yunxiao;Huang Chenglan;Hou Yutong;Yao Yuan;Zhao Yu;Xu Yuanjing;Yang Zezheng;Wang Jinwu(School of Rehabilitation Medicine,Weifang Medical University,Weifang 261053,Shandong Province,China;Department of Rehabilitation Medicine,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Institute of Translational Medicine,Shanghai Jiao Tong University,Shanghai 201100,China;School of Biomedical Engineering,Shanghai Jiao Tong University,Shanghai 201100,China;Department of Orthopedics,Shanghai Fifth People’s Hospital,Fudan University,Shanghai 200240,China;Department of Orthopedic Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]潍坊医学院康复医学院,山东省潍坊市261053 [2]上海交通大学医学院附属第九人民医院康复科,上海市200011 [3]上海交通大学转化医学研究院,上海市201100 [4]上海交通大学生物医学工程学院,上海市201100 [5]复旦大学附属上海市第五人民医院骨科,上海市200240 [6]上海交通大学医学院附属第九人民医院骨科,上海市200011

出　　处：《中国组织工程研究》2024年第24期3879-3884,共6页Chinese Journal of Tissue Engineering Research

基　　金：上海市科委项目(22015820100),项目参与人:王金武。

摘　　要：背景:退行性颈椎病患者一般存在颈椎曲度改变、颈肩部肌肉力量的不平衡及力量下降。目的:探讨退行性颈椎病矢状位曲度参数与颈肩部肌肉痛阈的相关性。方法:将2022年1月至2023年3月在上海交通大学医学院附属第九人民医院3D打印门诊中心收治的50例退行性颈椎病患者纳入研究,剔除颈椎X射线侧位片不符合测量条件的10例,拍摄颈椎侧位X射线片,测量Borden值、C_(2-7)Cobb角,并测量双侧上束斜方肌中点和C5-6棘突间旁1 cm处的疼痛阈值;分析退行性颈椎病矢状位曲度参数与颈肩部肌肉痛阈的相关性。结果与结论:①颈椎病矢状位曲度Borden值与左侧斜方肌上束痛阈、右侧斜方肌上束痛阈、C5-6棘突间旁左侧1 cm痛阈呈中等正相关关系(r=0.498,P<0.01;r=0.448,P<0.05;r=0.405,P<0.05),与C5-6棘突间旁右侧1 cm痛阈呈弱正相关关系(r=0.322,P<0.05);②C_(2-7)Cobb角与左侧斜方肌痛阈呈弱正相关关系(r=0.355,P<0.05),与右侧斜方肌痛阈、C5-6棘突间旁两侧1 cm痛阈不存在相关性;③颈肩部肌肉痛阈内部之间存在相关性,左右侧肌肉之间的痛阈及左右侧肌肉之内的痛阈皆存在高度相关性,提示颈肩部肌肉具有一致性,可能与颈肩部动作协同相关。BACKGROUND:Patients with degenerative cervical spondylosis often suffer from changed varicosity of the cervical spine,unbalanced neck-shoulder muscular strength,and descending power.OBJECTIVE:To probe into the correlation between sagittal curvature parameters and pain threshold for neck-shoulder muscles in degenerative cervical spondylosis.METHODS:Totally 50 patients with degenerative cervical spondylosis received treatment at the 3D Printed Outpatient Center of Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine from January 2022 to March 2023 were included in the study.After excluding the 10 patients of cervical lateral projection that failed to meet the measurement conditions,the cervical lateral projections were shot to measure the following iconography parameters:Borden value and C2-7 Cobb angle as well as pain thresholds on the midpoint of the superior trapezius muscle in bilateral bundles and at 1 cm beside the C5-6 interspike.The correlation between sagittal curvature parameters and pain threshold of neck-shoulder muscles in degenerative cervical spondylosis was analyzed.RESULTS AND CONCLUSION:(1)The Borden value of sagittal curvature showed a moderately positive correlation with the bundle pain threshold in the left upper trapezius muscle,the bundle pain threshold in the right upper trapezius muscle,and the pain threshold at the 1 cm of the left side beside the C5-6 interspike(r=0.498,P<0.01;r=0.448,P<0.05;r=0.405,P<0.05)and a weak positive correlation with the pain threshold at the 1 cm of the right side beside the C5-6 interspike(r=0.322,P<0.05).(2)The C2-7 Cobb angle showed a weak positive correlation with the left squared myalgia threshold(r=0.355,P<0.05),and there was no correlation with the pain threshold of the left trapezius muscle and the pain threshold at the 1 cm of both sides beside the C5-6 interspike.(3)There was a correlation between the pain threshold of the neck-shoulder muscles,and a high correlation between the pain threshold of the left and right muscle

关 键 词：退行性颈椎病 颈椎矢状位参数 Borden值 C_(2-7)Cobb角 疼痛阈值 颈部疼痛 相关性 影像学参数 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R493