无症状成人不同曲度颈椎矢状面参数相关性分析

The correlation analysis of sagittal parameters of cervical spine with different curvatures in asymptomatic adults

目的探讨无症状成人不同曲度颈椎矢状面参数相关性。方法分析180例无症状成人颈椎DR正、侧位片影像学资料,根据Borden测量法将体检者分为前凸组(120例)和非前凸组(60例)。比较矢状面各参数:C0~C2 Cobb角、C2~C7 Cobb角、T1倾斜角(TS)、胸廓入口角(TIA)、C2~C7椎体矢状面垂直距离(C2~C7 SVA)。采用Pearson相关系数分析颈椎矢状面各参数的相关性。结果C2~C7 Cobb角、TS两组比较差异均有统计学意义(P<0.01)。分析颈椎矢状面各参数的相关性:①前凸组:C0~C2 Cobb角与C2~C7Cobb角呈负相关,与C2~C7 SVA呈正相关;C2~C7Cobb角、TIA均与TS呈正相关;TIA、TS均与C2~C7 SVA呈负相关。②非前凸组:TIA与TS、C0~C2Cobb角与C2~C7SVA呈正相关;C2~C7 Cobb角与C2~C7 SVA呈负相关。结论无症状成人不同曲度颈椎矢状面参数相关性不同,提示不同曲度颈椎序列代偿机制可能不同,对于非前凸型成人,建议进行C2~C7 Cobb角、TS、TIA测量后综合评估以制定更合适的治疗方案。

Objective To invesigate the correlation of sagittal parameters of cervical spine with different curvatures in asymptomatic adults.Methods The positive and lateral DR image data of cervical spine in 180 asymptomatic adults were analyzed.According to Borden’s method,they were divided into lordosis group(120 cases)and non-lordosis group(60 cases).The sagittal parameters were measured:C0~C2 Cobb angle,C2~C7 Cobb angle,T1 tilt angle(TS),thoracic entrance angle(TIA)and C2~C7 sagittal vertical axis(C2~C7 SVA).Pearson correlation coefficient was used to analyze the correlation of the different sagittal parameters of cervical spine.Results There was significant difference for C2~C7 Cobb angle and TS between two groups(P<0.01).The correlation analysis of the sagittal parameters of the cervical spine:①In lordosis group,the C0~C2 Cobb angle was negatively correlative with C2~C7 Cobb angle,positively correlated with C2~C7 SVA;C2~C7 Cobb angle and TIA were positively correlated with TS;TIA and TS were negatively correlated with C2~C7 SVA.②In non-lordosis group:TIA was positively correlated with TS,C0~C2 Cobb angle was positively correlated with C2~C7 SVA;C2~C7 Cobb angle was negatively with C2~C7 SVA.Conclusions The sagittal parameters of cervical spine with different curvatures in asymptomatic adult have different correlation,remindering that the compensatory mechanism of cervical spine sequence with different curvature is different.For non-lordosis adults,the comprehensive evaluation of C2~C7 Cobb angle,TS,TIA after measuring are more helpful to formulate treatment plan.