脊髓型颈椎病与发育性颈椎椎管狭窄临床研究

Myelopathic type of cervical spondylosis and developmental stenosis of the cervical spinal canal

为探讨脊髓型颈椎病与发育性颈椎椎管狭窄的关系，测量了６０例正常人和１００例脊髓型颈椎病颈推侧位Ｘ线片的椎管矢状径和椎体矢状径，测量范围从Ｃ_２～Ｃ_７。结果：６０例正常人椎管矢状径平均值为（１６．６９±０．２５）ｍｍ；１００例脊髓型颈椎病椎管中矢径平均值为（１５．７±０．１７）ｍｍ。Ｃ_３～Ｃ_７椎管矢状径与椎体矢状径之比值平均值正常组为０．９０６，颈椎病组为０．７７４。颈椎３节以上比值小于０．７５者在正常组中无１例，脊髓型颈椎病组有４１例，两组差异有显著意义（Ｐ＜０．０１）。提示：发育性颈椎管狭窄是脊髓型颈椎病的一个重要发病因素。

The purpose of this study was to approach the relation between the myelopathic type of cervical spondylosis and the developmental stenosis of the cervical spinal canal.The antero-posterior and sagittal diameters of the cervical spinal canal were measured radiographically at the middle of the vertebrae in 60 normal Chinese individuals and in 100 cases of cervical spondylotic myelopathy.The range of measurement was at C_2 to C_7 level.The average diameter was 16.69 mm in the 60 normal Chinese individuals and it was 15.7 mm in 100 cases of cervical spondylotic myelopathy.In 60 normal controls,the ratio between the sagittal diameter of the cervical spinal canal and that of the corresponding vertebra was 0.906,while it was 0.774 in cases of spondylotic myelopathy.The ratio between the sagittal diameter of the cervical spinal canal and that of the corresponding vertebra was less than 0.75 in more than three levels.The diagnosis of developmental stenosis could be established.Forty-one of one hundred cases of cervical spondylotic myelopathy were associated with developmental stenosis of the cervical spinal canal.It is concluded that developmental stenosis of the cervical spinal canal is an important etiologic factor of cervical spondylotic myelopathy.