颈椎阻滞椎X线表现及特征

李俊桦; 王志宏; 李义凯

doi:10.13418/j.issn.1001-165x.2018.06.003

中国临床解剖学杂志 ›› 2018, Vol. 36 ›› Issue (6) : 611-614. DOI: 10.13418/j.issn.1001-165x.2018.06.003

断层影像解剖

颈椎阻滞椎X线表现及特征

李俊桦¹，　王志宏²，　李义凯³

作者信息 +

X - ray performance and characteristics of cervical vertebral block

LI Jun-hua¹, WANG Zhi-hong², LI Yi-kai³

Author information +

文章历史 +

摘要

目的　探讨颈椎阻滞椎的X线表现及特征。方法　回顾性分析125例颈椎阻滞椎X线资料，男性45例，女性80例，年龄24~75岁，平均年龄41.9岁，男女比例为1:1.77。分析其阻滞椎的发生节数、融合部位、骨赘发生、颈椎前凸曲度以及上、下椎间隙等情况。结果　本组病例中阻滞椎累及2个椎体100例，累及3个椎体5例，累及4个椎体17例，累及5个椎体3例。单节段阻滞椎以C2~3最多，共43例（43%）；其次是C3~4，共16例（16%）。融合部位：椎体及附件的同时融合82例（65.6%），单纯椎体融合28例（22.4%）。颈椎曲度变直或反张36例（28.8%）。椎体前/后缘骨赘110例（88%）；上椎间隙狭窄7例（5.6%）；下椎间隙狭窄15例（11.7%）；棘突融合52例（41.6%）；前纵韧带钙化19例（15.2%）；项韧带钙化17例（13.6%）；颅底凹陷症15例（12%）。结论　颈椎阻滞椎常表现为单节段的融合，椎体及附件的同时融合比单纯椎体融合多见。阻滞椎常伴有邻近节段的退行性改变及颅底凹陷。

Abstract

Objective　To investigate the X-ray performance and characteristics of cervical vertebral block.　Methods　The X-ray data of 125 patients with cervical vertebral block were retrospectively analyzed, including 45 males and 80 females, with an average age of 41.9 years old (male to female ratio was 1:1.77), ranging from 24 to 75. The number of nodes, fusion sites, the occurrence of callus, cervical lordosis curvature, and upper and lower vertebral space were analyzed. Results Cervical vertebrae block was involved 2 vertebrae in 100 cases, 3 vertebrae in 5 cases, 4 vertebrae in 17 cases, and 5 vertebrae in 3 cases. The single-segment fusion block was the most common in the C2~3 segment (43 cases, 43%), followed by the C3~4 segment (16 cases, 16%). Thirty-six cases (28.8%) of cervical curvature were straightened/anti-arched. Among the X-ray findings, vertebral anterior/posterior osteophytein was found in 110 cases (88%); stenosis in the upper disc space was found in 7 cases (5.6%); stenosis in the lower disc space was found in 15 cases (11.7%); spinous process fusion was found in 52 cases (41.6%); calcification of the anterior longitudinal ligament was found in 19 cases (15.2%); ligament calcification was found in 17 cases (13.6%); skull base depression was found in 15 cases (12%).　Conclusions　Cervical vertebral block often shows single-segment fusion. Simultaneous fusion of the vertebral body and attachment is more common than the vertebral body fusion alone. Cervical vertebral block is often accompanied by adjacent segment degeneration and basilar invagination.

导出引用

李俊桦,王志宏,李义凯. 颈椎阻滞椎X线表现及特征[J]. 中国临床解剖学杂志. 2018, 36(6): 611-614 https://doi.org/10.13418/j.issn.1001-165x.2018.06.003

LI Jun-hua, WANG Zhi-hong, LI Yi-kai. X - ray performance and characteristics of cervical vertebral block[J]. Chinese Journal of Clinical Anatomy. 2018, 36(6): 611-614 https://doi.org/10.13418/j.issn.1001-165x.2018.06.003

参考文献

[1] 张晓林, 马信龙, 杨阳. 阻滞椎的研究进展[J]. 北京医学, 2012, 34(5): 377-379.
[2] Samartzis D, Kalluri P, Herman J, et al. Cervical scoliosis in the Klippel-Feil patient[J]. Spine (Phila Pa 1976), 2011, 36(23): E1501-E1508.
[3] Laker SR, Concannon LG. Radiologic evaluation of the neck: a review of radiography, ultrasonography, computed tomography, magnetic resonance imaging, and other imaging modalities for neck pain[J]. Phys Med Rehabil Clin N Am, 2011, 22(3): 411-428, vii-viii.
[4] 李军朋, 李义凯, 王志宏. 四种颈椎曲度测量方法的可靠性研究[J]. 颈腰痛杂志, 2002, 23(4): 278-280.
[5] Woojin Cho, Dong-Ho Lee, Joshua D, et al. Cervical spinal cord dimensions and clinical outcomes in adults with klippel-feil syndrome: a comparison with matched controls[J]. Global Spine J, 2014, 4(4): 217-222.
[6] Xue X, Shen J, Zhang J, et al. Klippel-Feil syndrome in congenital scoliosis[J]. Spine (Phila Pa 1976), 2014, 39(23): E1353-E1358.
[7] Jawahir Y. Mohamed, Eissa Faqeih, Abdulmonem Alsiddiky, et al. Mutations in MEOX1, encoding mesenchyme homeobox 1, cause Klippel-Feil anomaly[J]. Am J Hum Genet, 2013, 92(1): 157-161.
[8] Ender Karaca, Ozge O. Yuregir, Sevcan T. Bozdogan, et al. Rare variants in the notch signaling pathway describe a novel type of autosomal recessive Klippel-Feil syndrome[J]. Am J Med Genet A, 2015, 167A(11): 2795-2799.
[9] RO Rosti. Of mice, men, and King Tut: autosomal recessive Klippel-Feil syndrome is caused by mutationsin MEOX1[J]. Clin Genet, 2013, 84(1): 19.
[10]Tredwell SJ, Smith DF, Macleod PJ, et al. Cervical spine anomalies in fetal alcohol syndrome[J]. Spine (Phila Pa 1976), 1982, 7(4): 331-334.
[11]Nguyen VD, Tyrrel R. Klippel-Feil syndrome: patterns of bony fusion and wasp-waist sign[J]. Skeletal Radiol, 1993, 22(7): 519-523.
[12]Ma X, Du Y, Wang S, et al. Adjacent segment degeneration after intervertebral fusion surgery by means of cervical block vertebrae[J]. Eur Spine J, 2018, 27(6): 1401-1407.
[13]Knoplich J. Isolated vertebral blocks in the cervical spine[J]. Rev Paul Med, 1992, 110(1): 2-7.
[14]Lee CK, Weiss AB. Isolated congenital cervical block vertebrae below the axis with neurological symptoms[J]. Spine (Phila Pa 1976), 1981, 6(2): 118-124.
[15]Leivseth G, Frobin W, Brinckmann P. Congenital cervical block vertebrae are associated with caudally adjacent discs[J]. Clin Biomech (Bristol, Avon), 2005, 20(7): 669-674.