脊髓型颈椎病患者骨密度变化与椎体变形及临床表现的相关性

Correlation of bone mineral density changes withvertebral deformation and clinical manifestations in patients with cervical spondylotic myelopathy

目的:分析脊髓型颈椎病患者骨密度变化与椎体变形及与临床表现的相关性。方法:选择2009-01/06在安徽医科大学第一附属医院运动医学科住院的脊髓型颈椎病患者42例,分为骨密度正常组20例,骨密度降低组22例,所有病例测量颈椎侧位片C3～6的椎管椎体矢状径比、椎体变形指数,并作两组之间临床表现的比较。结果:两组比较,骨密度降低组颈椎(C3,C4,C5,C6)椎管矢状径比值较骨密度正常组显著降低(P<0.05或P<0.01),而颈椎(C3,C4,C5,C6)椎体变形指数在两组之间则差异无显著性意义(P>0.05)。骨密度降低组临床症状与体征阳性率显著高于骨密度正常组(P<0.05)。结论:脊髓型颈椎病患者骨质疏松会导致椎体骨质增生,椎管狭窄,而骨密度降低患者临床表现更明显。

OBJECTIVE： To investigate the correlation of bone mineral density changes with vertebral deformation and clinical manifestations in patients with cervical spondylotic myelopathy. METHODS： A total of 42 cervical spondylotic myelopathy patients who received treatment at the Department of Sports Medicine, First Affiliated Hospital of Anhui Medical University from January to June 2009 were selected and randomly divided into the normal （n=20） and lower bone density （n=22） groups. The cervical lateral of the C3-6 spinal canal, sagittal diameter of vertebral body ratio, vertebral body deformation index in all cases was measured, and the clinical manifestations between two groups were compared. RESULTS： The cervical （C3, C4, C5, C6） sagittal diameter of vertebral body ratios of lower bone density group were significantly decreased than those of the normal group （P 0.05, or P 0.01）, and the cervical （C3, C4, C5, C6） vertebral body deformation indexes of the two groups showed no significant difference （P 0.05）; While the clinical manifestations （symptoms and physical signs） was significantly greater in the lower bone density group than the normal group （P 0.05）. CONCLUSION： Cervical myelopathy can cause osteoporosis in patients with vertebral bone hyperplasia, spinal stenosis, in particular, the clinical manifestations are more obviously in lower bone density patients.