唇腭裂患者颈椎异常的影像学表现

Cervical spine anomalies in patients with cleft lip and palate

目的观察唇腭裂患者颈椎异常的影像学表现,统计颈椎异常在唇腭裂患者中的比例及分布情况。材料与方法实验组304名6岁以上唇腭裂患者(男191人,女113人),对照组6岁以上非唇腭裂223人(男132人,女91人),应用头颅侧位片观察颈椎异常的表现。结果颈椎异常的表现类型分为后弓发育缺陷和融合两大类,其中,后弓发育缺陷分为椎弓裂、发育不足和寰枢对位不良三个亚类,融合分为寰枕融合和椎体融合两个亚类。寰枢对位不良在以往的研究中未曾报道。实验组中,55人(18.1%)发现颈椎异常,对照组中19人(8.5%)发现颈椎异常,差异有显著性。结论颈椎异常的表现类型分为后弓发育缺陷和融合两大类,发现新的表现类型寰枢对位不良。颈椎异常在唇腭裂患者中的发生比例高于非唇腭裂人群,差异有显著性。

Objective To examine the radiographic configurations of cervical spine anomalies, and to investigate the prevalence of the anomalies in patients with cleft lip and palate. Methods Three hundred and four patients （191 boys, 113 girls） aged 6 years or older, with cleft lip and palate were included in this study. Two hundred and twenty-three non-cleft subjects （132 boys, 91 girls） from orthodontic department were served as control group. Lateral cephalometric radiographs were assessed for morphological anomalies of the cervical spine. Results Cervical spine anomalies were classified into two types： posterior arch deficiency （PAD） and fusion anomalies （FUS）. PAD was subdivided into spina bifida, hypoplasia and atlantoaxial joint malposition; FUS was subdivided into occipitalization of the atlas and fusion between vertebrae. Atlantoaxial joint malposition was a new type that had not been reported before. In the total cleft sample, 55 patients （18. 1%） had cervical spine anomalies. In the control group, 19 subjects （8. 5%） had cervical spine anomalies. Difference was statistically significant between CP and non-cleft groups （p〈 0. 05）. Conclusion Cervical spine anomalies occured more frequently in patients with clefts as compared with non-cleft subjects.