屈伸检查在颈椎病X线诊断中的应用

X - ray diagnosis of cervical spondylosis by flexion - extension radiography

目的 探讨前屈—后伸位功能摄片在颈椎病X线诊断中的应用价值。方法 对本院100例颈椎病患者进行前屈及后伸颈椎侧位片检查,测量其前屈角、后伸角及相对角(前屈角—后伸角=相对角),观察椎体向前及/或向后滑移情况和棘突分离或相互靠近情况。结果 前屈角为85°～154°,平均130°。后伸角为42°～87°,平均62°。相对角32°～98°,平均67°。前屈位见颈椎椎体前移者71例,后移者5例,部分椎体前移部分椎体后移者2例;后伸位见颈椎椎体后移者82例;前屈位见局部棘突不能分离者13例;后伸位见局部棘突不能靠近者51例。结论 屈伸检查能发现常规颈椎正侧斜位片所未能显示的颈椎失稳和功能改变;有时还能发现常规片中未能显示或显示不清楚的解剖结构性改变;对X线观察颈椎运动,记录局部韧带损害,颈椎失稳及用以估计治疗后功能恢复的程度有重要作用。

Purpose To evaluate the value of flexion- extension radiography in the diagnosis of cervical spondylosis. Methods Lateral flexion- extension cervical spine radiography was performed on 100 patients with cervical spondylosis. The flexion, extension, and relative angles were measured on these films. The gliding of each verterbral body forward and/or backward, and the separation or close approximation of the sapinous processes were also evaluated. Results The range of the flexion angles was 85 to 154 degrees(average 130 degrees) , the extension angles 42 to 87 degrees(an average of 62 degrees)and the relative angles 32 to 98 degrees(67 degrees on average). Seventy - one patients showed the gliding of the vertebral bodies forward,5 backward, and 2 had both anterio and posterior displacement seen on the flexion radiographs. Eighty - two patients showed the vertebral bodies gliding posterioly seen on the extension radiographs. Thirteen patients failed to show the separation of the regional spinal processes on the flexion films, while 51 patients could not revealed the close approximation of the spinal processes on the extension films. Conclusion The flexionextension studies may reveal not only the cervical instability, the limiation of cervical movement but sometime even the anatomical structural chansges not seen on the conventional cervical spine radiographs. It plays an important role not only in the observation of the cervial movement, the segmental ligamentous damage and the cervical instability, but also in the evaluation of the functional improvement upon later reexamination after the therapeutic measures.