退变性颈椎失稳颈后深部肌肉的组织化学特征及其临床意义

Histochemical study and clinical significance of the cervical posterior deep muscles with degeneration cervical spinal instability

目的：研究颈后深部肌肉的肌纤维型分布和横切面积，探讨其生理功能和在退变性颈椎失稳发病中的作用。方法：应用肌球蛋白ＡＴＰ酶染色法，观察正常人（４例）和退变性颈椎失稳患者（４例）颈后深部肌肉各型肌纤维的比例和结构特征，并测量肌纤维的横切面积。结果：正常人和退变性颈椎失稳患者颈后深部肌肉Ⅰ型和Ⅱ型纤维交织排列，横切面呈多边形或椭圆形，Ⅰ型纤维数量及横切面积均显著大于Ⅱ型纤维。退变性颈椎失稳患者肌纤维边界不清，横切面上可见小空泡，Ⅰ型纤维减少，Ⅱ型纤维增多。结论：颈后深部肌肉对维持颈段脊柱的生理姿势和运动起重要作用，肌纤维病理学改变是退变性颈椎失稳发病的重要因素之一。

Objective:To observe the distribution of fiber types and its sectional areas of the cervical posterior deep muscles and to detect its physiological function and pathological effect on the degenerative cervical spinal instability. Medthods:The proportion and structure of various type fibers of the cervical posterior deep muscles were observed by histochemical stains for myosin ATPase in 4 normal adults and 4 patients with degenerative cervical spinal instability.The sectional area of fibers was measured also.Results:The type Ⅰ and type Ⅱ fibers arranged interweavely and showed multiside or ellipes.The number and section area of type Ⅰ fiber were larger than that of type Ⅱ fiber significantly in normal human and patient.For patient,the number of tyep Ⅰ were less and type Ⅱ more than those of normal.The border of the fiber was not clear and there were small vacuoles on the section of fiber in patients. Conclusions:The cervical posterior deep muscles play an important role in maintaining the physiological posture and movement function of the cervical spine.The pathological changes of the fibers might be one of the important causes of degenerative cervical spinal instability.