颈椎矢状位参数与颈后肌群质量的相关性

Correlation between cervical sagittal parameters and posterior cervical muscles mass

目的分析颈椎中立位及动力位矢状位参数与颈后肌群质量的相关性,探讨颈后肌群在颈椎矢状面形态与平衡的动态调节中的作用及意义。方法回顾性分析2018年6月—2019年7月收治的80例中老年颈椎病患者临床及影像学资料,在影像学资料上测量过屈、过伸及中立位颈椎矢状位C_(2~7)Cobb角、C_(0~2)Cobb角、C_(7)倾斜角(C_(7)S)、颈椎矢状位垂直轴(cSVA)及其变化值,并运用相关性分析,评估颈后肌群平均功能性横截面积(fCSA)与颈椎矢状位参数及其变化量的相关性。结果C_(2~7)Cobb角、C_(0~2)Cobb角、C_(7)S及cSVA在不同位置时的差异均有统计学意义(P<0.05)。颈后肌群平均fCSA与C_(7)S、cSVA明显相关,与C_(2~7)Cobb角、C_(0~2)Cobb角无明显相关性;颈后肌群平均fCSA与C_(7)S变化量明显相关,与C_(2~7)Cobb角变化量、C_(0~2)Cobb角变化量及cSVA变化量无明显相关性。结论颈后肌群肌肉质量与C_(7)S变化量有相关性,中老年颈椎病患者可能通过颈后肌群改变颈椎“底座”倾斜率而非颈椎曲度,实现颈椎矢状面形态与平衡的动态调节。

Objective To analyze the correlation between neutral and dynamic cervical sagittal parameters and the mass of posterior cervical muscle group for exploring the role and significance of posterior cervical muscle group in dynamic adjustment of cervical sagittal morphology and balance.Methods Clinical and imaging data of 80 middle-aged and elderly patients with cervical spondylosis from June 2018 to July 2019 were retrospectively analyzed.C_(2-7) Cobb angle,C_(0-2) Cobb angle,C_(7) slope(C_(7)S)and cervical sagittal vertical axis(cSVA)in the hyperflexion,hyperextension and neutral positions were measured on imaging data.The correlation analysis was used to evaluate the correlation between the mean functional cross-sectional area(fCSA)of posterior cervical muscle group and cervical sagittal parameters and their changes.Results There were significant differences in C_(2-7) Cobb angle,C_(0-2) Cobb angle,C_(7)S and cSVA at different positions(P<0.05).The mean fCSA of posterior cervical muscle group was significantly correlated with C_(7)S and cSVA,but not with C_(2-7) Cobb angle and C_(0-2) Cobb angle.The mean fCSA of posterior cervical muscle group was significantly correlated with change of C_(7)S,but not with changes of C_(2-7) Cobb angle,C_(0-2) Cobb angle and cSVA.Conclusion The posterior cervical muscle group mass is correlated with the change of C_(7)S.In middle-aged and elderly patients with cervical spondylosis,the posterior cervical muscle group may change the tilt rate of the cervical“base”rather than the total cervical curvature,thus achieving the dynamic adjustment of cervical sagittal morphology and balance.