仰卧前屈拔伸牵引对神经根型颈椎病患者有效椎管横截面积的影响

The Effect of Supine Flexion Traction on the Effective Cross-sectional Area of Spinal Canal in Patients with Cervical Spondylotic Radiculopathy

目的:观察仰卧前屈拔伸牵引对神经根型颈椎病患者有效椎管横截面积的影响,探讨其改善有效椎管横截面积、减轻脊髓压迫的可能性。方法:纳入神经根型颈椎病患者30例,其主要压迫节段均为C4~7任一节段,压迫区域均位于椎管内,并已行仰卧前屈拔伸牵引、中立位、后伸位三种状态下的颈椎动态磁共振检查。利用Image J软件测量每个患者三种状态下主要压迫节段的有效椎管横截面积,并进行对比分析。结果:30例患者在仰卧前屈拔伸牵引下的平均有效椎管横截面积为(147.79±28.87)mm^2,中立位为(137.45±31.97)mm^2,后伸位为(118.50±31.23)mm^2,三者之间差异明显(P<0.01)。结论:在三种状态下,有效椎管横截面积存在明显的变化规律:仰卧前屈拔伸牵引>中立位>后伸位,提示仰卧前屈拔伸牵引法能增大神经根型颈椎病患者有效椎管横截面积,减轻脊髓压迫,提供一定的修复空间,为防止脊髓进一步受压导致病情进展提供可能性。

Objective:To observe the effect of supine flexion traction on the effective cross-sectional area of spinal canal in patients with Cervical Spondylotic Radiculopathy,and to explore the possibility of improving the effective cross-sectional area of spinal canal and reducing the compression of spinal cord.Methods:30 cases of cervical spondylotic radiculopathy were included.The main compression segments were involved C4~7 segment.The compression regions were all located in the spinal canal.Dynamic MRI of cervical spine was performed in three statuses:supine flexion traction,neutral position and extension.Image J software was used to measure the effective cross-sectional area of the main compression segments of each patient in three statuses,and the results were compared and analyzed.Results:The average effective cross-sectional area of spinal canal was(147.79±28.87)mm^2 in supine flexion traction(137.45±31.97)mm^2 in the neutral position and(118.50±31.23)mm^2 in back extension position,and there are obvious differences among the three statuses(P<0.01).Conclusion:In three statuses,the effective cross-sectional area of spinal canal has obvious changes:supine flexion traction>neutral position>back extension position,which suggests that supine flexion traction can increase the effective cross-sectional area of spinal canal,reduce the compression of spinal cord,provide a space for repair,and provide the possibility to prevent the further compression of spinal cord leading to the progress of the disease.