颈神经在椎间孔与脊神经沟处受嵌压的出现率比较(英文)

Comparison of the occurrence rates of cervical nerve entrapment at cervical intervertebral foramen and spinal nervous sulcus

背景:椎间盘髓核向侧后方脱出以及神经根管内的软组织炎性肿胀可直接或间接压迫神经根,但颈神经在椎间孔及脊神经沟处的嵌压因素与严重性待进一步研究。目的:探讨颈神经在椎间孔及脊神经沟处受嵌压的出现率与颈椎病严重程度关系。设计:单一样本研究。单位:承德医学院解剖教研室、附属医院老年病科、教务处。对象:实验选用承德医学院解剖教研室提供的经甲醛固定成尸60具,男28,女32;共120侧。方法:取60具成尸,测量颈椎间孔及其脊神经根的外径以及对脊神经沟外口宽度及其沟内段脊神经前支横径,数据进行统计学处理。主要观察指标:颈神经前支横径/脊神经沟宽度和颈神经根外径/椎间孔大小的均值,比值≥1的出现率。结果:颈神经根与椎间孔之比值明显大于脊神经与脊神经沟之比值(t=2.66,P<0.01);颈神经在椎间孔处受压的出现率(24.6%)明显高于脊神经沟处(6.3%),二者比较差异有非常显著性意义(χ2=6.95,P<0.01)。结论:颈神经在颈椎间孔和脊神经沟处均可受累,颈神经在椎间孔处受累的严重性明显大于在脊神经沟处。临床诊治颈椎病在充分考虑椎间孔处神经受累的同时,也不可忽视颈椎脊神经沟处神经受累的可能性。

BACKGROUND:Nerve root could be directly or indirectly entrapped due to lateral backward prolapse of nucleus pulposus of intervertebral disc,as well as parenchymal inflammatory tumefaction of the soft tissues in nerve root tube.But the factors and their severity related to cervical nerve entrapment at cervical intervertebral foramen and spinal nervous sulcus still need further studies. OBJECTIVE:To investigate the relationship between the occurrence rate of cervical nerve entrapment at cervical intervertebral foramen and spinal nervous sulcus and the severity of cervical syndrome. DESIGN:A single sample study. SETTING:Department of Anatomy,Department of Geriatrics of the Affiliated Hospital,and Department of Teaching Affairs, Chengde Medical College. PARTICIPANTS:The research was conducted in the Department of Anatomy,Chengde Medical College.Totally 120 sides of 60 cadavers(28 males and 32 females) were provided by the Department of Anatomy. METHODS:The outside diameters of cervical intervertebral foramen and spinal nerve root,as well as the width of external opening of spinal nerve sulcus and transverse diameter width of the anterior branch of intra spinal nerve were measured,and the data were dealt with statistically. MAIN OUTCOME MEASURES:The ratio of transversal diameter of the forepart of cervical nerves to the width of spinal nerve sulcus;the ratio of the peripheral diameter of cervical nerve roots to the size of intervertebral foramen;the occurrence rate where the ratio was ≥1. RESULTS:The ratio between cervical nerve root and intervertebral foramen was significantly larger than that between spinal nerve root and spinal nerve sulcus(t=2.66,P< 0.01).The occurrence rate of cervical nerve entrapment at the intervertebral foramen(24.6%) was higher than that in spinal nerve sulcus(6.3%),and the difference had a considerable statistical significance(χ2=6.95,P< 0.01). CONCLUSION:It is suggested that the spinal nerve may be entrapped in the cervical intervertebral foramen and the spinal nervous sulcus,and the spinal nerve lesions in the cervical intervertebral foramen was more serious than in the spinal nervous sulcus.Therefore,in clinic,when diagnosing and treating cervical spondylosis,while nerve entrapment at the intervertebral foramen is fully considered,the possibility of nerve entrapment at the spinal nervous sulcus should not be neglected.