颈椎病患者项韧带钙化的影响因素分析

Factors affecting ligamentum nuchae calcification in patients with cervical spondylosis

目的:探讨颈椎病患者发生项韧带钙化与颈椎椎间隙高度、颈椎影像学参数的关系。方法:回顾性分析2020年6月至2023年6月皖南医学院第二附属医院确诊的124例颈椎病患者的临床资料,所有患者均接受颈部X线片、CT检查,根据患者是否发生项韧带钙化分为钙化组83例、非钙化组41例,对比两组患者颈椎各节段椎间隙高度、局部Cobb角、颈椎曲度分型、Jackson生理应力曲线、临床症状等指标,分析引起颈椎病患者发生项韧带钙化的危险因素。结果:钙化组患者的年龄大于非钙化组、病程长于非钙化组,差异均有统计学意义(P均<0.05);钙化组患者C4~5和C5~6的椎间隙高度均小于非钙化组,差异均有统计学意义(P均<0.05);钙化组患者C4~5和C5~6的局部Cobb角均小于非钙化组,差异均有统计学意义(P均<0.05);钙化组患者直型颈椎曲度患者占比、VAS评分均高于非钙化组,Jackson生理应力曲线低于非钙化组,差异均有统计学意义(P均<0.05)。Logistic回归分析显示,患者的年龄越大、病程越长、颈椎曲度呈直型、VAS评分高、C4~5和C5~6的椎间隙高度降低是颈椎病患者项韧带发生钙化的独立危险因素(P均<0.05)。结论:C4~5和C5~6的椎间隙高度减小、颈椎曲度呈直型会增加颈椎病患者发生项韧带钙化的风险,通过矫正椎间隙高度及颈椎曲度有助于降低项韧带钙化风险。

Objective:To investigate the relationships between the occurrence of ligamentum nuchae calcification in patients with cervical spondylosis and changes in the cervical intervertebral disc height and cervical imaging parameters.Methods:A retrospective analysis was conducted on the clinical data of 124 patients diagnosed with cervical spondylosis at the Second Affiliated Hospital of Wannan Medical College from June 2020 to June 2023.All patients underwent cervical anteroposterior and lateral X-ray and CT examinations.Patients were divided into a calcification group(83 cases)and a non-calcification group(41 cases)based on the presence of ligamentum nuchae calcification.The cervical intervertebral disc height of each segment,local Cobb angle,cervical curvature classification,Jackson stress curve,and clinical symptoms were compared between two groups to identify the risk factors for ligamentum nuchae calcification.Results:Patients in the calcification group were significantly older and had longer disease durations than those in the non-calcification group(both P<0.05).The intervertebral disc heights at C4-5 and C5-6 in the calcification group were significantly lower than those in the non-calcification group(both P<0.05).The local Cobb angles at C4-5 and C5-6 in the calcification group were also significantly smaller than those in the non-calcification group(both P<0.05).The proportion of patients with straight cervical curvature and VAS scores in the calcification group were significantly higher than those in the non-calcification group,while the Jackson stress curve was significantly lower than that in the non-calcification group(all P<0.05).Logistic regression analysis revealed that older age,longer disease duration,straight cervical curvature,higher VAS score,and decreased intervertebral disc height at C4-5 and C5-6 were independent risk factors for ligamentum nuchae calcification in patients with cervical spondylosis(all P<0.05).Conclusions:Decreased intervertebral disc height at C4-5 and C5-6 and straight cervical curvature increase the risk of ligamentum nuchae calcification in patients with cervical spondylosis.Correcting the intervertebral disc height and cervical curvature can help reduce the risk of ligamentum nuchae calcification.