颈椎钩突关节骨质增生对椎动脉的影响

The Effect of Osseous Hypertrophy of Cervical Luschka's Joints on Vertebral Artery

目的：使用三维CT曲线重建技术，显示颈椎钩突关节骨质增生对椎动脉的影响。材料与方法：用三维CT重建技术显示24例椎动脉型颈椎病患者的钩突关节骨质增生和椎动脉的关系。共观察192个钩突关节。RT线测量：上下椎体外缘的切线至钩突关节最外侧点垂直距离，即RT线。根据RT线的长度，将钩突关节对椎动脉的影响分为3度。1度：RT线≤1mm，椎动脉平直；2度：RT线为2～3mm，椎动脉迂曲；3度：RT线≥4mm，椎动脉狭窄。结果：三维CT曲线重建能直接显示椎动脉的迂曲／狭窄，1度改变者占77％；2度改变者为18％；3度改变者为5％，其中，C4、5和C5、6钩突关节骨质增生所引起的椎动脉迂曲和狭窄占91．0％。91.7％的患者有双侧椎动脉的迂曲／狭窄。结论：三维CT曲线重建技术能直接显示钩突关节和椎动脉的关系，对椎动脉型颈椎病的诊断和治疗有重要意义。

Objective: To demonstrate the effect of osseous hypertrophy of cervical Luschka's joints on vertebral artery (VA) with three-dimen-sional CT(3DCT) curved reformation technology. Materials and Methods: 24 cases of cervical spondylisis who had vertebral insufficiency were examined with 3DCT. The relationship of Luschka's joints and VA were shown. RT line was measured from cutting-line of lateral cortical margins of the cervical vertebra to outer cortical margines of Luschka's joints. According to the length of RT line, the cases were classified into 3 types. Type Ⅰ: RT line≤ 1mm, with straight VA. Type II: RT line = 2～3mm, with curved VA. Type III: RT line≥4mm, with narrow VA. Results: Type Ⅰ had 148/192 (77% ), Type II had 35/192 (18% ), type III had 9/192 (5% ); type I and Ⅲ were related to vertebral insufficiency; Of type Ⅱ and Ⅲ, 40/44 (91 % ) lied at C_4、5 and C_5、6. 91 % cases showed curved / narrow VA on bath sides. Conclusion: The relationship of Luschka's joints and VA can be demonstrated directly with curved reformation of 3DCT, which is very driportant in the diagnosis and treatment of vertebral insufficiency.