中青年颈椎间盘突出症的CT对照分析

CT Analysis of Young and Middle-aged Cervical Disc Herniation

目的探讨无症状组及有症状组中青年颈椎间盘突出症在CT上的区别。方法搜集无症状及有症状中青年受检者300例及125例,对两组颈椎间盘突出的临床及CT表现特点进行对照分析。结果有症状组椎间盘突出检出率为81.2%(102/125),突出椎间盘198节,突出程度3.63±0.20mm,椎管狭窄8.6%(17/198),黄韧带肥厚19.2%(38/198),椎体及椎小关节增生40.9%(81/198),无症状组椎间盘突出检出率为42.3%(127/300),突出椎间盘159节,突出程度2.13±0.11mm,椎管狭窄1.3%(2/159),黄韧带肥厚8.2%(13/159),椎体及椎小关节增生35.2%(56/159)。两组除椎体及椎小关节增生外均有明显统计学差异(P<0.05)。结论有症状组在椎间盘突出检出率、突出程度、椎管狭窄、黄韧带肥厚等方面均较无症状组明显,颈椎间盘突出达3.6mm以上或合并椎管狭窄、黄韧带肥厚者发展为颈椎病的可能性较大,应予以早期治疗。CT可以早期发现颈椎间盘突出、突出程度等信息,是颈椎间盘突出症重要检查方法。

Objective To investigate the difference of cervical disc herniation between asymptomatic and symptomatic young and middle -aged patients in CT （computed tomography）. Methods Three hundrend asymptomatic and 125 symptomatic young and middle - aged examinees were collected, and the clinical and CT performances of the two cervical disc herniation groups were analyzed. Results The results of symptomatic group were as follows ： the relevance ratio of protrusion of intervertebral disc was 81.2% （ 102/125 ） , protruded discs were 198 joints with the degree of protrusion of 3.63 ± 0.20mm, vertebral canal stenosis was 8.6% （17/198） , hypertrophy of ligament falvum was 19.2% （38/198） , centrum and intervertebral facet joints hyperplasia was 40.9% （81/198）. And the results of asymptomatic group were as follows： the relevance ratio of protrusion of intervertebral disc was 42.3% （127/300） , protruded discs was 159 joints with the degree of protrusion of 2.13 ±0. 11 mm, vertebral canal stenosis was 1.3 % （2/159） , hypertrophy of ligament falvnm was 8.2% （13/159） , centrum and intervertebral facet joints hyperplasia was 35.2% （56/159）. All parameters, except for centrum and intervertebral facet joints hyperplasia in two groups, had significant statistics difference（ P 〈 0.05 ）. Conclusion The relevance ratio of protrusion of intervertebral disc, the degree of protrusion, vertebral canal stenosis and hypertrophy of ligament falvum, in symptomatic group were less distinct than those in asymptomatic group. The possibility to develop into cervical spondylosis, which needed early treatment, was greater if cervical disc herniation had reached above 3.6mm or had association with vertebral canal stenosis or hypertrophy of ligament falvum. CT may find cervical disc herniation and the degree of protrusion in the early stage, which is an important checking method of cervical disc herniation.