青年人颈源性头痛与颈椎不稳相关性研究

Young people cervicogenic headache associated with cervical spine instability studies

目的：探讨青年人颈源性头痛（CEH）与颈椎不稳的之间的相关性。方法：对临床诊断CEH的青年患者64例赴行颈椎X线检查，在过伸过屈位X片上测量椎体间角度位移和水平位移，在自然例位X片上记录颈椎曲线，并与30例正常人进行对照。结果：CEH组有43例（67．2％）共55个节段有颈椎不稳，其中C3／417例，C4／531例，C5／66例，C6／71例；正常时照组有3例（10％）共3个节段有颈椎不稳，其中C4／51例、C跏2例。两组颈椎不稳例数比较X^2检验差异存在显著性意义（P〈O．01）。CEH组颈椎曲线异常57例（89％），其中颈椎变直36例，反曲8例，折曲或S型弯曲13例。正常对照组颈椎曲线异常2例（6．7％），两组比较X。检验差异有显著性意义（P〈0．01）。本组颈椎曲线异常或／和颈椎不稳共计62例，异常率96．9％。结论：青年人CEH与颈椎不稳密切相关，颈椎不稳很可能是导致临床CEH及其相关症状主要病因，临床上应重视颈椎不稳的诊治．

Objective：To explore the correlation between cervicogenic headache （CEH） and cervical spine instability in young people. Methods：Cervical spine X--ray examination was carried out in 64 young patients with clinical diagnosis of CEH and was com- pared with 30 health controls. Angle and horizontal displacement between vertebral bodies were measured in flexion--extension （FE） radiographs. Cervical curves were recorded on the X--ray of neutral position and lateral. Results：Cervical instability were existed in 43 patients （67.2%） and 55 cervical segments of CEH group. Among all the cervical instability, there were 17 cases accoured in C3/4, 31 cases in C4/5, 6 cases in C5/6 and 1 case in C6/7. Cervical instability were existed in 3 cases （10%） and 3 cervical segments of health control. There were 1 case accoured in C4/5 and 2 cases in C5/6. X2 test to compare the number of two groups of cases with cervical instability showed significant difference （P〈0.01）. There were 57 cases （89%） abnormal cervical curve in CEH group, in which 36 cases became straight, 8 cases became contrary flexure and 13 cases became flex or S--shaped bend. Abnormal cervical curve occurred in 2 cases （6.7%） of the control group, X2 test showed significant difference （P〈0.01） between these two groups. The total number of abnormal cervical curve and / or cervical instability was 62 cases, abnormal rate of 96.9 %. Conclasion：CEH are closely related to cervical instability in young people. Cervical spine instability is likely to be the major cause that lead to clinical symptoms of CEH. It should be pay attention to the clinical diagnosis and treatment of cervical spine instability.