严重椎间隙狭窄颈椎病的影像学特征△

Radiographic features of cervical spondylosis complicated with severe intervertebral space stenosis

摘要:

[目的] 分析严重椎间隙狭窄颈椎病的影像学特征。[方法] 将 C_2/3或 C_3/4椎间隙称之为参考椎间隙，将椎间隙狭窄最严重的间隙称之为目标椎间隙，如果目标椎间隙高度小于或等于参考椎间隙高度的 50%定义为严重椎间隙狭窄。回顾性分析 2019 年 1 月—2022 年 2 月 132 例严重椎间隙狭窄颈椎病患者的影像指标测量结果，分析不同节段间测量指标的变化，探讨它们之间的相关性。[结果]132 例患者中，严重椎间隙狭窄累及 1~4 个椎间隙，共累及 225 个椎间隙。不同节段发生严重椎间隙狭窄的概率依次为：C_5/6为 79.6%，C_6/7为 56.1%，C_4/5为 28.0%；C_3/4为 6.8%。各节段之间椎间隙高度、颈椎整体曲度 C_2~7 Cobb 角、局部 Cobb 角、中立位各节段棘突间距、动力位下各节段棘突间距，以及椎间孔高度、宽度及面积的差异均有统计学意义 （P＜0.05）。相关性分析方面，椎管面积与椎间隙高度、局部 Cobb 角、动力位棘突间距变化呈正相关（P＜0.05），但与 C₂~C₇Cobb 角、中立位棘突间距没有相关性（P＞0.05）。椎间孔面积与椎间隙高度、局部 Cobb 角、动力位棘突间距变化有呈显著正相关（P＜ 0.001），与 C₂~C₇ Cobb 角、中立位棘突间距没有相关性（P＞0.05）。[结论] 严重椎间隙狭窄最常见于 C_5/6椎间隙，其次是 C_6/7椎间隙。椎间孔面积与椎间隙高度、局部 Cobb 角、动力位棘突间距变化有显著相关性。

Abstract:

[Objective] To explore the radiographic features of cervical spondylosis complicated with severe intervertebral space steno- sis. [Methods] The C_2/3 or C_3/4 intervertebral space was referred to as the reference intervertebral space, while the space of the most severe in- tervertebral space stenosis was referred to as the target intervertebral space. Severe intervertebral space stenosis was defined if the target in- tervertebral space height was less than or equal to 50% of the reference intervertebral space height. A retrospective study was conducted on 132 patients who were diagnosed of cervical spondylosis complicated with severe intervertebral space stenosis in our department from Janu- ary 2019 to February 2022. The radiographic measurements among different segments were analyzed to explore the correlation between them. [Results] Among 132 patients, the severe intervertebral stenosis affected 1 to 4 intervertebral spaces, with a total of 225 intervertebral spaces involved. Incidence of the severe intervertebral space stenosis in different segments was ranked as 79.6% in C_5/6, 56.1% in C_6/7, 28.0% in C_4/5 and 6.8% in C_3/4. There were significant differences among all segments in terms of intervertebral space height, C_2~7 Cobb angle (cervi- cal lordotic curvature), local lordotic Cobb angle, spinous process distance in neutral position, spinous process distance in dynamic position, and the height, width and area of intervertebral foramens (P＜0.05). Regarding to correlation analysis, the spinal canal area was positively cor- related with intervertebral space height, local Cobb angle and dynamic spinous process spacing (P＜0.05), whereas not correlated to C₂~C₇ Cobb angle and neutral spinous process interval (P＞0.05). In addion, the intervertebral foramen area was positively correlated with interverte- bral space height, local lordotic Cobb angle and dynamic spinous process interval (P＜0.001), whereas not correlated to the C₂~C₇ Cobb angle and neutral spinous process interval (P＞0.05). [Conclusion] The severe intervertebral space stenosis most commonly occurres in C_5/6 inter- vertebral space, followed by C_6/7 intervertebral space. The intervertebral foramen area is significantly correlated with intervertebral space height, local lordotic Cobb angle and dynamic spinous process interval.