颈椎后凸畸形患者颈椎曲度运动规律及与正常人重力线的比较
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国家自然科学基金(81271988)


Clinical significance of spinal motion in flexion and extension relative to the head gravity line in cases of cervical kyphosis
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    摘要:

    目的:探讨颈椎后凸畸形患者矢状位上颈椎曲度和重力线的改变,为临床颈椎后凸畸形的矫形提供参考。方法:对60例颈椎后凸畸形患者颈椎侧位片-过伸过屈片进行测量,测量A-B-C角,并计算3个角在屈伸运动中的变化值。选取60例颈椎正常人计算颈椎弧形的顶点和D值,比较他们和颈椎后凸畸形患者的区别和联系。结果:中立位时,A角平均值为正值,自C2~C7该值逐渐增大;过伸位时,A角平均值减少,减少的幅度逐渐减少;过屈位时,A角平均值增加,增加的幅度仍逐渐减少。B角变化规律和A角相似,但其平均值大于A角。在屈伸运动中,上位椎体A角变化(D角)基本等于下位椎体A角变化和此两椎体之间C角的变化之和(E角)。颈椎后凸畸形患者在屈伸运动变化的过程中,弧度的顶点上下移动在C4~C5,与正常人一致。但颈椎后凸畸形患者的C值和齿突后缘到C7椎体后缘的间距(D值)与正常人相比,有显著差异。结论:在颈椎屈伸的变化过程中,后凸畸形患者与正常人具有相同的规律,颈椎曲度的变化是以顶椎为中心,在矢状面上的旋转和位移造成的。本研究揭示了颈椎后凸畸形椎体在动态运动中的变化和规律,为颈椎后凸畸形的矫形奠定了理论基础。

    Abstract:

    Objective:To investigate the changes in cervical curvature relative to the gravity line in cervical kyphosis and to provide better reference for orthopedic treatment. Methods:Measurements were performed on 60 patients with cervical kyphosis in the sagittal view in the standard,hyper flexion,and hyper extension position including∠A-∠B-∠C,and A,B and C were calculated to ascertain the value of the changes during cervical flexion and extension. The apex of the cervical curve was determined to compare changes in the distribution characteristics with 60 normal people as well as the D value. Results:In standard position,∠A was positive and increased from C2 to C7. In hyper extension position,∠A was decreased and the reduction in amplitude decreased from C2 to C7,while in hyper flexion position,∠A increased and the increase in amplitude decreased from C2 to C7. ∠B followed similar patterns of change with a larger mean value. During cervical flexion and extension,change in ∠A of the upper vertebral body(∠D) was almost equal to change in ∠A of the lower vertebral body and change in ∠C between the two vertebral bodies(∠E). The curve apex was mainly distributed between C4 and C5. Conclusion:During cervical flexion and extension movement,the dynamic changes and regularities of cervical kyphosis patients is consistent with normal people. Cervical vertebral body movement is a rotation and displacement based on a central apex in the sagittal plane during dynamic flexion and extension in both cervical kyphosis patients and normal people. The correction of the cervical kyphosis can be carried out from the apex of the cervical spine,which lays a solid theoretical foundation for the correction of the cervical kyphosis.

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周灵杰,恽 波,殷 建,凡 进,方加虎,殷国勇.颈椎后凸畸形患者颈椎曲度运动规律及与正常人重力线的比较[J].南京医科大学学报(自然科学版),2016,(9):1111-1115

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  • 收稿日期:2016-04-03
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  • 在线发布日期: 2016-09-18
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