目的 通过CT和MR影像探讨颈椎关节突关节退变与矢状位序列改变及轴性疼痛的关系。 方法 回顾2019年1月~2022年1月就诊我科的颈椎病患者156例，根据颈椎CT，分为观察组（关节突退变组）72例，平均年龄（51.0±12.3）岁，对照组（关节突正常组）84例，平均年龄（48.0±11.4）岁，记录轴性疼痛发生率及疼痛程度；在颈椎MR上测量C2~C7 cobb角，C2~7矢状位轴向距离（sagittal vertical axis，SVA），T1倾斜角（T1 Slope，T1S），胸廓入射角（thoracic inlet angle，TIA），颈倾角（neck tilt，NT），胸椎后凸角（thoracic kyphosis，TK），并记录椎间盘退变评分。 结果 轴性疼痛患者观察组65例，VAS（6.4±1.3）分，对照组30例，VAS（3.3±0.9）分，差异有统计学意义（P=0.00）；椎间盘退变评分，观察组和对照组分别为（4.9±1.1）分和（2.5±0.7）分，差异有统计学意义（P=0.00）；颈椎矢状位参数测量，关节突退变组T1S为（27.5±5.4）°，对照组为（22.1±4.8）°，差异值5.4°，P=0.00；两组间TK差异值4.1°（P=0.00）；两组TIA（P=0.18）、NT（P=0.34）、C2~C7 Cobb（P=0.08）、SVA（P=0.08）均无统计学差异。 结论 颈椎关节突退变与轴性疼痛正相关，T1S和TK增大可能与关节突关节退变有关。
Abstract
Objective To explore the relationship between cervical articular process joint degeneration and sagittal sequence changes as well as axial pain through CT and MR imaging. Methods A retrospective analysis was conducted on 156 patients with cervical spondylosis who visited our department from January 2019 to January 2022. Based on cervical CT imaging, patients were divided into an observation group (articular process degeneration group) of 72 patients with an average age of (51±12.3) years and a control group (normal articular process group) of 84 patients with an average age of (48±11.4) years. The incidence and severity of axial pain were recorded. Cervical MR images were used to measure the C2-C7 Cobb angle, sagittal vertical axis (SVA) distance from C2 to C7, T1 slope (T1S), thoracic inlet angle (TIA), neck tilt (NT), and thoracic kyphosis angle (TK). Additionally, the degree of intervertebral disc degeneration was recorded. Results In the observation group, 65 patients experienced axial pain with an average VAS score of (6.4±1.3), while in the control group, 30 patients experienced axial pain with an average VAS score of (3.3±0.9), with statistical difference (P=0.00). The intervertebral disc degeneration scores for the observation and control groups were (4.9±1.1) and (2.5±0.7), respectively, with a statistically significant difference between the two groups (P=0.00). Among the measured cervical sagittal parameters, the T1S angle was (27.5°±5.4°) in the articular process degeneration group and (22.1°±4.8°) in the control group, showing a significant difference of 5.4° (P=0.00). There was also a significant difference in the TK angle between the two groups difference of 4.1° (P=0.00). However, there were no statistically significant differences in TIA (P=0.18), NT (P=0.34), C2-C7 Cobb angle (P=0.08), and SVA (P=0.08) between the two groups. Conclusions Cervical articular process degeneration is positively correlated with the occurrence of axial pain. The increase in T1S and TK may be related to articular process joint degeneration.
关键词
颈椎病； /
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关节突关节； /
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矢状位参数； /
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轴性疼痛
Key words
Cervical spondylosis; /
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Facet joint; /
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Sagittal parameters; /
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Axial pain
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基金
天津市卫生健康委员会科技项目青年项目（TJWJ2022QN040）；天津市人民医院院级科研基金（2019JZPY08）
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