颈椎力线变化对C4/5椎间孔影像测量的影响

Impact of cervical alignment variation on imaging measurement of C4/5 intervertebral foramen

摘要:

[目的] 探讨影像测量颈椎力线变化对 C_4/5节段椎间孔的影响。[方法] 选取本院 2022 年 1 月—2023 年 5 月行颈椎 X 线及 CT 检查且资料完整的受测试者共 162 例，根据 Borden 氏颈椎力线测量法将其分为前凸组 52 例、变直组 79 例、后凸组 32 例。观察 C_4/5节段椎间孔形态，测量其椎间孔高度（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、后缘高度，分析比较各组测量结果。[结果]规则椎间孔，包括圆形、类圆形、方形占比分别为前凸组 83.7%，变直组 53.5%，后凸组 45.2%。C_4/5椎间隙前缘高度依次为前凸组＞变直组＞后凸组 [(4.1±0.5) mm vs (3.7± 0.5) mm vs (3.2±0.4) mm, P＜0.001]。但是，变直组较前凸组和后凸组的 FH [(9.7±0.8) mm vs (9.1±0.1) mm vs (9.2±0.8) mm, P＜0.001] 和 FA [(0.5±0.1) mm² vs (0.4±0.7) mm² vs (0.5±0.7) mm² , P=0.001] 明显增大。三种状态下 C_4/5左右两侧的的 FH、FW 和 FA 的差异均无统计学意义（P＞0.05）。[结论]颈椎力线变化可显著引起 C_4/5节段椎间孔形态变化，变直可引起 C_4/5节段 FW、FA 增加和椎间隙前缘高度减小，后凸可导致 C_4/5节段的 FW 减小及椎间隙前后缘高度丢失。

Abstract:

[Objective] To investigate the effect of cervical alignment variation on imaging measurement of C_4/5 intervertebral foramen. [Methods] A total of 162 subjects who underwent cervical X-ray and CT examination with complete data in our hospital from January 2022 to May 2023 were enrolled into this study. Of them, 52 cases were fall into the lordotic group, 79 cases were in the straightening group, and 32 cases were classified into the kyphotic group according to Borden's method of cervical alignment. The morphological parameters of C_4/5 were measured, including foraminal height (FH), foraminal width (FW), foraminal cross-sectional area (FA), and the anterior and posterior heights of the vertebral space. The data were compared among the 3 conditions. [Results] The proportion of regular foramen, including round, quasi-round and square, was 83.7% in the lordotic group, 53.5% in the straightening group and 45.2% in the kyphotic group respectively. The anterior height of C_4/5 intervertebral space was ranked as the lordotic group ＞ the straightening group ＞ the kyphotic group [(4.1± 0.5) mm vs (3.7±0.5) mm vs (3.2±0.4) mm, P＜0.001]. However, the straightening group got significantly greater FH [(9.7±0.8) mm vs (9.1±0.9) mm vs (9.2±0.8) mm, P＜0.001] and FA [(0.5±0.1) mm² vs (0.4±0.7) mm² vs (0.5±0.7) mm² , P=0.001] than the lordotic and kyphotic groups. There were no significant differences in terms of FH, FW and FA between the left and right sides of C_4/5 in the three states (P＞0.05). [Conclusion] The change of cervical alignment does significantly cause the morphological variation of the intervertebral foramen at C_4/5 level. The straightening cervical spine increases FW and FA at C_4/5 level, while decreases the anterior and posterior height of the intervertebral space. The kyphosis decreases FW at C_4/5 level with loss of the anterior and posterior height of the intervertebral space.