颈椎矢状位参数C_(2)-C_(7)矢状面轴向距离的研究进展  

Clinical research and application status of cervical sagittal parameters C_(2)-C_(7) SVA

作　　者：秦泽瑞 冉宇 沙宗硕 穆晓红[1] 李晋玉[1] 陈江[1] Qin Zerui;Ran Yu;Sha Zongshuo;Mu Xiaohong;Li Jinyu;Chen Jiang(Orthopedics Department,Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine,District 1,Beijing,100700;School of Life Sciences,Beijing University of Traditional Chinese Medicine,Beijing,102488;School of Management,Beijing University of Traditional Chinese Medicine,Beijing,102488)

机构地区：[1]北京中医药大学东直门医院骨伤科一区,北京100700 [2]北京中医药大学生命科学学院,北京102488 [3]北京中医药大学管理学院,北京102488

出　　处：《中华骨科杂志》2025年第7期454-462,共9页Chinese Journal of Orthopaedics

基　　金：国家自然科学基金面上项目(82374492);北京中医药大学揭榜挂帅项目(2024-JYB-JBZD-060)。

摘　　要：C_(2)-C_(7)矢状面轴向距离(sagittal vertical axis,SVA)是评估颈椎生物力学的核心指标,贯穿了颈椎疾病发生、发展和预后的全过程,被广泛应用于颈椎矢状位平衡和功能状态的评估。目前通常将C_(2)-C_(7) SVA<25 mm视为颈椎矢状位平衡的标准,而C_(2)-C_(7) SVA>40 mm则被认为是颈椎矢状位失衡或畸形的标志。C_(2)-C_(7) SVA的增加会导致颈椎生物力学失衡,并进一步加重颈部肌肉的静态和动态负荷,从而引发肌肉疲劳和疼痛。短期内可诱发颈部轴性症状,长期还增加了颈椎间盘退变、神经根型颈椎病和脊髓型颈椎病等的患病风险。术后C_(2)-C_(7) SVA增大增加了邻近节段的压力,导致椎间盘和关节的过度负荷,从而引发邻近节段退行性改变。在术后疗效的短期评估和长期随访中,C_(2)-C_(7) SVA的增大通常预示着较差的手术预后,而有效控制SVA值则与良好的功能恢复密切相关。因此,保持C_(2)-C_(7) SVA在正常范围内(<25 mm),不仅有助于优化治疗效果,还能显著减少术后并发症的发生,改善患者的生活质量。The C_(2)-C_(7) sagittal vertical axis(SVA)is an essential biomechanical parameter for evaluating cervical spine alignment,and it is integral to the pathogenesis,progression,and prognosis of cervical spine disorders.This parameter is widely used in evaluating cervical sagittal balance and functional status.Internationally,a C_(2)-C_(7) SVA of less than 25 mm is considered within the cervical range for sagittal balance,while values exceeding 40 mm indicate cervical sagittal imbalance or deformity.An increased C_(2)-C_(7) SVA disrupts cervical spine biomechanics,leading to heightened static and dynamic loads on the cervical musculature.This,in turn,results in muscle fatigue and discomfort.In the short term,patients may experience axial neck symptoms,while a sustained elevation in SVA over time significantly raises the risk of cervical disc degeneration,radiculopathy,and myelopathy.Additionally,a higher C_(2)-C_(7) SVA postoperatively places excessive stress on adjacent spinal segments,which can accelerate degeneration of intervertebral discs and facet joints,contributing to adjacent segment degeneration.Both short-term and long-term postoperative evaluations have shown that an increase in C_(2)-C_(7) SVA is typically associated with poorer surgical outcomes,whereas effective control of SVA values is closely linked to better functional recovery.Therefore,in clinical practice,maintaining C_(2)-C_(7) SVA within the normal range(<25 mm)is critical not only for optimizing treatment results but also for significantly reducing postoperative complications and improving overall patient quality of life.

关 键 词：颈椎 放射学 颈椎病 功能状态 C_(2)-C_(7)SVA 颈椎矢状位参数 

分 类 号：R681.5[医药卫生—骨科学]