老年颈椎病颈椎椎体结构改变及其意义

The Structural Changes and Significance of Cervical Vertebrae in Senile Cervical Spondylosis

目的 :研究老年颈椎病颈椎椎体结构的病理改变及其意义。方法 :( 1)在X线片上测定 35例老年 ( >6 0岁 )颈椎病的椎体平均高度和平均矢状径长度 ,用其比值来判定椎体的变形程度 ,与 15例青壮年外伤性颈椎病患者相比。 ( 2 )老年组 2 4例 ,青壮年组 12例行颈椎前路钻孔减压 ,术中取颈椎椎体松质骨行透射电镜观察。结果 :( 1)两组椎体变形指数差异显著 (P <0 .0 5 )。 ( 2 )实验组骨细胞多处于退变相和溶骨相 ,而对照组多为成骨相和静止相。实验组与对照组相比成骨细胞功能低下而破骨细胞数量多且功能活跃。结论 :老年颈椎病颈椎椎体骨小梁的异常改建是骨细胞性骨吸收 ,破骨细胞性骨吸收和成骨细胞功能低下共同作用的结果 ,其可致椎体畸变 。

Objective:To investigate the structural changes and significance of cervical vertebrae in senile cervical spondylosis(SCS).Methods:(1)The average altitude and sagittal diameter of the vertebral body were measured in X ray film(35 cases of SCS).(2)Cancellous bone chips taken from the cervical bone (24 SCS cases,12 control cases) during operation were prepared for TEM.Results:(1)There is significance between groups.(2)The osteocytes of cancellous bone of control belonged to formative and resorptive phases,but in SCS they belonged to resorptive and degenerative ones.Compared with cells in control osteoblasts showed inactive function while osteoclasts have more active functions in SCS.Conclusions:The degeneration of osteocytes and osteoblasts together with the active functions of osteoclasts results in abnormal trabecular structures in SCS,this can lead to vertebral deformity and accelerate the cervical spondylosis.