摘要
目的探讨一种新的成人下颈椎关节突关节退变的评级方法,为临床观测提供量化的评级标准。方法选用20例在读学生为正常组和40例颈椎病患者为病理组,分别行螺旋CT扫描并重建,测量下颈椎关节突关节横断面长度、宽度及关节间隙大小,计算出正常值范围;制定下颈椎关节突关节退变的评级标准。数据用SPSS 13.0统计软件包进行统计学分析,计算正常组、病理组各数据的均数及标准差;同一关节突关节左右数据间比较行配对t检验,正常组和病理组同一节段的各数据比较用独立样本t检验。结果 (1)正常组下颈椎关节突关节各测量数据左右差异均无统计学意义,取双侧均值。C3-4、C4-5、C5-6、C6-7关节突关节横断面长度分别为:(10.84±0.94)mm、(11.57±0.85)mm、(11.83±0.96)mm、(12.57±0.88)mm;关节突关节横断面宽度分别为:(10.44±0.99)mm、(10.56±0.91)mm、(10.50±1.06)mm、(9.49±0.68)mm;关节间隙中部(J2)最大,分别为:(1.49±0.12)mm、(1.44±0.10)mm、(1.43±0.09)mm、(1.45±0.11)mm;关节间隙两侧(J1、J3)略窄且基本对称。(2)病理组下颈椎关节突关节各测量数据左右差异均无统计学意义,取双侧均值。C3-4、C4-5、C5-6、C6-7关节突关节横断面长度分别为:(10.83±0.83)mm、(11.44±0.85)mm、(12.26±0.70)mm、(12.67±0.74)mm;关节突关节横断面宽度分别为:(10.55±0.98)mm、(10.98±1.06)mm、(10.96±0.85)mm、(9.75±0.81)mm;关节间隙中部(J2病)最大,分别为:(1.34±0.17)mm、(1.30±0.27)mm、(1.34±0.17)mm、(1.25±0.12)mm;关节间隙两侧(J1病、J3病)略窄且基本对称。(3)正常组和病理组间比较:C5-6关节面长度间差别有统计学意义;C4-5、C5-6关节面宽度间差别有统计学意义;C3-4、C4-5、C5-6、C6-7关节间隙大小间差别均有统计学意义;病理组关节突关节退变的特征表现为:关节突肥大、骨赘形成、关节面不规则、关节间隙狭窄、软骨下骨坏死、软骨下骨囊性变。结论自行设计的一种新的下颈椎关节突关节退变的评级标准,分为0-Ⅲ级,该评级标准是一个简单实用的影像学评估方法。
Object To explore a new method of the assessment of facet joint degeneration,providing quantitative ratings - criterion for the clinical observations.Methods Twenty students in normal group and forty cervical spondylosis patients in pathological group underwent CT scanning and reconstruction.Lower cervical facet joint cross - sectional length, width and joint space size were measured and the normal range was calculated.Rating criterion of lower cervical facet joint degeneration was formulated.All the data were analyzed by SPSS13.0,and the mean and standard deviation in both normal group and pathological group were calculated.The same facet joint between left and right was compared using the paired T test,and the same segment between normal group and pathological group using the independent samples T test. Results（1） The difference is not statistically significant,which were compared that the two sides measurements of lower cervical facet joints in the normal group,got the averaged measurements of both sides.Facet joint cross - sectional length of C34,C4-5,C5-6,C6-7：（10.84±0.94） mm,（11.57±0.85） mm,（11.83±0.96） mm,（12.57±0.88） mm;facet joint cross - sectional width：（10.44±0.99） mm,（10.56±0.91） mm,（10.50±1.06） mm, （9.49±0.68） mm;central joint space size（J2） were the most：（1.49±0.12） mm,（1.44±0.10） mm,（1.43±0.09） mm,（1.45±0.11） mm;joint space on both sides（J1,J3） are slightly narrower and the basic symmetry. （2） The difference is not statistically significant,which were compared between the two sides measurements of lower cervical facet joints in the pathological group,got the averaged measurements of both sides.Facet joint cross - sectional length of C34,C4-5,C5-6,C6-7：（10.83±0.83） mm,（11.44±0.85） mm,（12.26±0.70） mm,（12.67±0.74） mm;facet joint cross - sectional width：（10.55±0.98） mm,（10.98±1.06） mm,（10.96±0.85） mm, （9.75±0.81） mm;central joint space size（J2-ill） were the most;（1.34±0.17） mm,（1.30±0.27 ） mm, （1.34±0.17） mm,（1.25±0.12） mm;joint space on both sides（J1 - ill,J3 - ill） are slightly narrower and the basic symmetry.（3） The comparisons of length of C5-6 between normal and pathological are statistically meaningful;the comparisons of width of C4-5,C5-6 between normal and pathological are statistically meaningful;the comparisons of joint space size of C3-4,C4-5,C5-6,C6-7 between normal and pathological are statistically meaningful.Degeneration of pathology group facet joints group of facet joint pathology is characterized by facet hypertrophy,osteophyte formation,articular surface irregularity,joint space narrowing,subchondral bone destruction and subchondral bone cystic.Conclusion Self- designed rating criteria of degeneration of lower cervical facet joints is new,which can be divided into 0 -Ⅲgrade and is a simple and helpful method.
出处
《中国骨与关节外科》
2010年第6期433-441,共9页
Chinese Journal of Bone and Joint Surgery
基金
广东韶关市科技计划项目(韶科-卫2010-14)
