颈椎生理曲度变化对C4/5节段椎间孔影响的影像学测量研究[作者简介：冯哲，主治医师，研究方向：脊柱外科，（电话）15909836721，（电子信箱）[e-mail] *通讯作者：杨玉宝，主任医师，医学博士，（电话）13666397588,（电子信箱）[e-mail]]

Imaging study on the effect of physiological curvature of cervical vertebrae on intervertebral foramen in C4/5 segment

摘要:

摘要 目的：通过影像学测量探讨颈椎生理曲度（颈曲）变化对C4/5节段椎间孔的影响。方法：选取本院2022年1月～2023年5月在门诊行颈椎X线侧位片和颈椎三维 CT检查且资料完整的病人162例，根据Borden氏颈椎生理曲度测量法将其分为颈曲正常组（A组）52例、颈曲变直组（B组）79例、颈曲反弓组（C组）31例。观察测量三组间C4/5节段椎间孔形态、椎间孔高度（foraminal height， FH）、椎间孔宽度（foraminal width，FW）、椎间孔横截面积（foraminal area，FA)和椎间隙的前缘和后缘高度，分析比较各组测量结果并探讨其临床意义。结果：A、B、C三组间在C4/5节段的椎间孔的形态和间隙高度存在显著差异，B组较 A组椎间孔高度和横截面积明显增大（P<0.05）,椎间隙前缘高度明显减小（P<0.05），而椎间孔宽度和椎间隙后缘高度无明显差异（P>0.05）；C组的椎间隙前缘和后缘高度较A组和B组都明显减小（P<0.05），椎间孔宽度较A组和B组也都明显减小（P<0.05），而椎间孔高度和横截面积较 A组无明显差异（P>0.05）。结论：颈曲异常（变直和反弓）可显著引起 C4/5节段椎间孔形态不规则。颈曲变直可引起C4/5节段椎间孔高度、横截面积增加和椎间隙前缘高度减小，颈曲反弓更易导致 C4/5节段的椎间孔宽度变窄、椎间隙高度丢失。

Abstract:

Abstract: Objective:To explore the influence of the changes of physiological curvature (cervical curvature) of cervical vertebra on the intervertebral foramen of C4/5 segment by imaging measurement. Methods:A total of 162 patients with complete data were selected for cervical X-ray lateral film and three-dimensional CT examination in the outpatient clinic from January 2022 to May 2023. According to Borden''s cervical physiological curvature measurement, the patients were divided into three groups: normal cervical curvature group (group A, n = 52), cervical curvature straightening group (group B, n = 79) and cervical curvature reversal group (group C, n = 31). The shape of intervertebral foramen, the foraminal height(FH), the foraminal width(FW), the foraminal area(FA) and the height of anterior and posterior edge of intervertebral space were observed and measured among the three groups. The results of each group were analyzed and compared and its clinical significance was discussed.Results:There were significant differences in intervertebral foramen morphology and intervertebral space height among groups A, B and C in the C4/5 segment. The FH and FA of the C4/5 intervertebral foramen were significantly increased in group B compared with group A (P<0.05), the height of the anterior disc was significantly reduced (P <0.05), but, there was no significant difference in FW (P>0.05).The height of anterior and posterior edge of intervertebral space in group C was significantly lower than that in group A and group B (P<0.05), and the FW in group C was significantly smaller than that in group A and group B (P<0.05), but the FH and FA of intervertebral foramen in group C were not significantly different from those in group A (P>0.05).Conclusions: Abnormalities of cervical curvature (straightening and reverse arch) can significantly cause irregular shape of intervertebral foramen in C4/5 segment. The straightening of cervical curvature can cause the increase of intervertebral FH and FA，and decreasing of anterior edge height of intervertebral space in C4/5 segment, and the cervical curvature reverse arch is more likely to lead to narrowing of FW and loss of intervertebral space height in C4/5 segment.