颈椎椎间隙后缘骨赘的影像学测量与临床意义

Imaging measurement and clinical significance of posterior marginal osteophyte of cervical vertebral intervertebral space

目的通过对颈椎椎间隙后缘骨赘的影像学测量,研究其临床意义。方法选取2016年9月至2017年12月收治的88例颈椎病患者(男36例,女52例),术前摄颈椎X线片,调阅PACS系统影像,以椎体下、上终板的切线(a线,b线)分别将相邻颈椎后缘骨赘分为上、下部(A上,A下,B上,B下),使用Auto CAD 2014版软件测量各部骨赘面积,计算切线上下骨赘面积与同侧骨赘总面积(A总,B总)的比值(Mean±SD)。结果本研究中后缘骨赘分为4型:Ⅰ型占61.36%,Ⅱ型5.68%,Ⅲ型10.22%,Ⅳ型22.72%。颈椎椎间隙后缘骨赘多发生于C5/6,占所有节段的43.18%。各节段的性别差异无统计学意义(P>0.05)。上位椎体下缘a线以上存在骨赘者占总数比为32.94%,A上骨赘面积占该A总骨赘总面积的(41.18±15.45)%。下位椎体上缘b线以下存在骨赘者占总数比为28.40%,B下骨赘面积占该B总骨赘总面积的(54.69±22.49)%。结论在颈前路椎间盘切除减压融合术前通过分析颈椎后缘骨赘的影像学类型,规划术中处理后缘骨赘,可以达到更好的脊髓减压效果。

Objective To study the clinical value of cervical osteophytes in posterior margin of intervertebral space by imaging measurement.Methods 88 patients with cervical spondylosis,among which of 36 males and 52 females,were selected from September 2016 to December 2017.X-ray of cervical spine was taken,the system imaging of PACS was consulted before operation.The posterior edge osteophytes of cervical spine were divided into upper and lower parts(Aupper,Alower,Bupper,Blower)based on the tangent line of upper and lower endplate of the vertebral body respectively(Line a,Line b).The area of osteophytes of each part were measured by Auto CAD 2014 software.The ratio of the area of osteophytes of upper and lower parts and the total area of osteophytes of the same side(Aall,Ball)were calculated(Mean±SD).Results The posterior margin osteophytes were classified into four types.Type I accounted for 61.36%of the measured data,type II 5.68%type III 10.22%,and type IV 22.72%.Posterior marginal osteophytes of cervical intervertebral space were mainly located in C5/6,accounting for 43.18%of all segments.There was no statistical significance in gender of different segments.The percentage of osteophytes above the line-a of the lower edge of the upper vertebral body was 32.94%.The ratio of the area of Aupperosteophytes to the total area of Aallosteophytes was(41.18±15.45)%.The percentage of osteophytes below the line-b of the upper edge of the lower vertebral body was 28.40%.The ratio of Blowerosteophyte area to total Ballosteophyte area was(54.69±22.49)%.Conclusions By analyzing the imaging types of osteophytes in posterior margin of cervical vertebra before operation,planning the treatment of osteophytes in posterior margin during operation,decompression-fusion of discectomy can obtain better effect in reducing pressure of spinal cord.