优秀男子业余拳击运动员颈椎损伤流行病学调查及X线特征分析

The Prevalence and X-Ray Characteristics of Cervical Injury in Elite Boxers

目的:研究优秀男子业余拳击运动员颈椎损伤情况,分析其常见症状、体征的分布特征及X线特征。方法:以国家拳击队、河南省拳击队61名优秀男子业余拳击运动员为研究对象,由运动创伤专业医师对其进行颈部损伤的症状调查和体征检查;并为其中30名有头部受重击受伤史且伴有颈痛症状者拍摄颈椎X线正侧位、双斜位片进行观察和测量。对所获数据进行统计分析。结果:共计61例样本中,有头部受重击史49人,占80.3%。列前4位的症状依次是颈痛(68.9%)、颈性头晕(62.3%)、颈性头痛(49.2%)和颈部活动受限(39.3%)。C2棘突旁压痛、C2-3小关节压痛、枕下三角压痛等3个阳性体征出现频率最高,皆为38人(62.3%);颈性头痛、颈性头晕、颈痛、颈部活动受限、枕下三角压痛、C2棘突压痛、C2-3小关节压痛等7个症状和体征的发生与头部受重击密切相关。30例X线样本中,棘突偏离中线以C2最多(96.7%),棘突偏歪整体分布自上而下逐渐减少;小关节双边征以C3-4分布频率最高(53.3%);颈曲均值为26.59±1.93°,明显小于正常人群;椎间孔狭窄以C3-4最多(40%)。结论:优秀男子业余拳击运动员颈椎损伤特点是上位颈椎损伤几率较高;X线特征是棘突偏歪自上而下逐渐减少,小关节双影以C3-4出现率最高,颈椎曲度明显小于普通人群,C3-4和C4-5椎间孔狭窄发生率较高;头部受重击是拳击运动员颈椎损伤的主要致病因素之一。

Objective In this study,the prevalence,x-rays characteristics,and common clinical manifestation of cervical vertebrae injury in elite boxers were investigated.Methods A questionnaire survey on cervical vertebrae injury was carried out.Sixty one boxers from Chinese national and Henan provincial level boxers were involved in this survey.Their symptoms and signs of cervical injury were investigated.Measurement of X-ray cervical vertebrae was performed in 30 of 49 subjects with the history of heavy thump on head and cervicodynia.Data obtained were analyzed by the SPSS17.0 software.Results Forty nine of 61 had the history of head thump（80.3%）.Symptoms after head thump included headache（80.3%）,dizziness（62.3%）,cervicodynia（68.9 %）,limitation of neck motion（39.3%）;Tenderness on the spinal process of C2,on articular process of C2-3,and on occipital triangle（62.3%） was relatively common.In X-ray films of 30 cases,unsymmetrical spinous process of C2（96.7%）,double contour sign of C3-4（53.3%）,less cervical curvature（26.59 ± 1.93°）and angusty of foramen intervertebrale of C3-4（40%） were the most common signs.Conclusion The results showed that there is a higher injury rate of cervical spine,especially its upper part,in the elite boxer.Heavy thump on head is one of the risk factors of cervical injury in boxer.