颈部发育性椎管狭窄下颈段的影像学特征

Radiologic feature of inferior cervical vertebrae in developmental canal stenosis

目的研究颈椎发育性椎管狭窄（developmental spinal canal stenosis,DCS）患者下颈段影像学特征。方法选择颈椎DCS患者（DCS组）36例和正常志愿者（对照组）16例。入选对象均行颈部CT、MRI扫描。测量并比较2组C3~C7椎弓根最长层面的椎管正中矢状径、椎管横径、骨性椎管横截面积、硬膜囊横截面积、脊髓横截面积、椎弓根外宽度、椎弓根轴线长度、椎弓根横向长度、侧块纵向直径、侧块横径、椎板外宽度、椎板长度。结果 DCS组C3~C5水平骨性椎管横截面积、硬膜囊横截面积小于对照组。DCS组C6、C7椎弓根外宽度小于对照组,C4椎弓根轴线长度小于对照组,C5侧块横径小于对照组,C3、C6侧块长径小于对照组。结论对颈椎DCS进行后路螺丝钉固定时,应当较非DCS更为小心,以避免损伤血管神经。

Objective To elucidate the radiologic feature of inferior cervical vertebrae in developmental spinal canal stenosis（DCS）.Methods Thirty-six patients diagnosed DCS and 16 healthy controls with age and gender matched in our hospital were included in the study.All subjects had undergone cervical scan by both CT and MRI.The following parameters were measured：spinal canal longitudinal diameter,spinal canal transverse diameter,osseous spinal canal area,dural sac area,spinal cord area,pedicle outer width,pedicle axis length,pedicle transverse angulation,lateral mass longitudinal diameter,lateral mass transverse diameter,lamina outer width,and lamina axis length.Results The mean osseous spinal canal area and dural sac area at C3-C5 in DCS group were less than those in the control group.The mean pedicle outer width at C6 and C7in DCS group was less than that in control group.The mean pedicle axis length at C4 in DCS group was less than that in control group.The mean lateral mass transverse diameter at C5 and mean lateral mass longitudinal diameter at C3,C6 in DCS group were less than those in control group.Conclusion Myelopathy is expected to progress in patients with DSC and the patients with severe neurologic symptoms may need cervical operation.However,posterior screw insertions should be considered more carefully than in non-DCS patients.