断层影像解剖

颈椎关节突关节矢状位角的不对称性和关节突关节退变关系的影像学研究

展开
  • 1.南昌大学第一附属医院神经外科,  南昌   330006;   2.南昌大学第三附属医院骨科,  南昌  330003;   3.南昌医学院,  南昌330036;    4.南昌大学第四临床医学院,  南昌   330003;     5.南昌大学第四附属医院骨科,  南昌   330003;    6.南昌大学第四附属医院放射科,  南昌   330003;   7.南方医科大学人体解剖学教研室, 广州   510515;   8.暨南大学医学院解剖教研室, 广州   510632
徐聪(1976-),男,江西南昌人,博士,主任医师,硕士研究生导师,主要从事脊柱脊髓的基础与临床研究,Tel: (0791)87692532, E-mail:635784655@qq.com

收稿日期: 2020-03-31

  网络出版日期: 2021-09-29

基金资助

国家自然科学基金项目(31460273);江西省自然科学基金项目(20151BAB205052)

Imaging study on the relationship between sagittal angle asymmetry of cervical facet joint and cervical facet joint degeneration

Expand
  • 1. Department of Neurosurgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China; 2.Department of Orthopedics, the Third Affiliated Hospital of Nanchang University, Nanchang 330003, China; 3. Nanchang Medical College, Nanchang 330036, China; 4. The Fourth Clinical Medical College of Nanchang University, Nanchang 330003, China;  5. Department of Orthopaedics, the Fourth Affiliated Hospital of Nanchang University, Nanchang 330003, China; 6. Department of Radiology, the Fourth Affiliated Hospital of Nanchang University, Nanchang 330003, China; 7. Department of Anatomy, Southern Medical University, Guangzhou 510515, China; 8. Department of Anatomy, Jinan University, Guangzhou 510632, China

Received date: 2020-03-31

  Online published: 2021-09-29

摘要

目的    探讨颈椎关节突关节矢状位角的不对称性和关节突关节退变的关系。  方法    利用4度评估法,3位测评者对20具新鲜尸体颈椎标本的轴向位CT图像上C3/4 ~ C6/7节段共160个关节突关节矢状位角和退变程度进行单盲随机测评,并统计分析。  结果    20具颈椎标本在不同节段间的关节突关节矢状位不对称角度无显著性差异(F=0.55,P=0.65),关节突关节退变程度也无显著性差异(左侧:Z=3,P=0.646;右侧:Z=3,P=0.376),但C3/4和C4/5的关节突关节矢状位角的不对称程度与同节段关节突关节退变的程度之间有显著的差异性(C3/4:Z=8.567,P=0.014;C4/5:Z=2.000,P=0.025)。  结论    关节突关节矢状位角的不对称性可能和关节突关节的退变有关。

本文引用格式

徐聪, 徐庆平, 艾雯, 江凯燕, 袁佳, 吴炳华, 尹生江, 毕振宇, 焦培峰 . 颈椎关节突关节矢状位角的不对称性和关节突关节退变关系的影像学研究[J]. 中国临床解剖学杂志, 2021 , 39(5) : 535 -538 . DOI: 10.13418/j.issn.1001-165x.2021.05.007

Abstract

Objective    To investigate the relationship between sagittal angle asymmetry of cervical facet joint and the degeneration of cervical facet joint.    Methods   The sagittal facet angle and the degeneration degree of 160 facet joint at C3/4-C6/7 segments on the axial CT of 20 fresh cervical cadaver specimens were evaluated blindly and statistically analyzed by 3 reviewers using the 4-degree evaluation method.    Results   There was no significant difference in sagittal asymmetrical angles of the facet joint between different segments (F= 0.55,P=0.65), and  there was also no significant difference in the degeneration of cervical facet joint (left: Z=3, P=0.646; right: Z=3, P=0.376) between different segments, but there were significant differences between the sagittal angle asymmetry of cervical facet joint and the degeneration of cervical facet joint  at C3/4 and C4/5 segments of 20 fresh cervical cadaver specimens(C3/4:Z=8.567, P=0.014,C4/5; Z=2.000, P=0.025).   Conclusion    The sagittal angle asymmetry of cervical facet joint may be related to the degeneration of the facet joint.

参考文献

[1]  王怀云, 何海龙, 李华, 等. 颈椎关节突关节面倾角测量特点及临床意义. 脊柱外科杂志, 2011, 9(6): 357-359. DOI: 10.3969/j.issn.1672-2957.2011.06.010.
[2]  Brailsford JF. Deformities of the lumbosacral region of the spine[J]. Br J Surg, 1928, 16: 526-627.
[3]  Noren R, Trafimow J, Andersson GB, et al. The role of facet joint tropism and facet angle in disc degeneration[J]. Spine, 1991, 16(5): 530-532. DOI: 10.1097/00007632-199105000-00008.
[4]  Berlemann U, Jeszenszky DJ, Bühler DW, et al. Facet joint remodeling in degenerative spondylolosthesis: an investigation of joint orientation and tropism[J]. Eur Spine J, 1998, 7(5): 376-380. DOI: 10.1007/s005860050093.
[5]  Boden SD, Riew KD, Yamaguchi K, et al. Orientation of the lumbar facet joints:association with degenerative disc disease[J]. J Bone Joint Surg Am, 1996, 78(3): 403-411. DOI: 10.2106/00004623-199603000-00012.
[6]  Pathria M, Sartoris DJ, Resnick D. Osteoarthritis of the facet joints: accuracy of oblique radiographic assessment[J]. Radiology, 1987, 164(1): 227-230. DOI: 10.1148/radiology.164.1.3588910.
[7]  Kim HJ, Chun HJ, Lee HM, et al. The biomechanical influence of the facet joint orientation and the facet tropism in the lumbar spine[J]. Spine J, 2013, 13(10): 1301-1308. DOI: 10.1016/j.spinee.2013.06.025.
[8]  Poureisa M, Behzadmehr R, Daghighi MH, et al. Orientation of the facet joints in degenerative rotatory lumbar scoliosis: an MR study on 52 patients[J]. Acta Neurochirurgica (Wien), 2016, 158(3): 473-479. DOI: 10.1007/s00701-015-2690-3.
[9]  徐聪, 于雪峰, 廖琦, 等. MRI和CT在测评退行性颈椎滑脱关节突关节矢状位不对称角中可靠性的比较[J]. 中国临床解剖学杂志, 2016, 34(1): 63-67. DOI:10.13418/j.issn.1001-165x.2016.01.017.

[10]Fujiwara A, Tamai K, An HS, et al. Orientation and osteoarthritis of the lumbar facet joint[J]. Clin Orthop Relat Res, 2001, 385: 88-94. DOI: 10.1097/00003086-200104000-00015.    

[11]Cyron BM, Hutton WC. Articular tropism and stabilityof the lumbar spine[J]. Spine, 1980, 5(2): 168-172. DOI: 10.1097/00007632-198003000-00011.
[12]张继业, 朱青安, 姜欢畅, 等. 腰椎小关节不对称与小关节退变程度的关系及临床意义[J]. 中国临床解剖学杂志, 2010, 28(6): 629-633. DOI: 10.13418/j.issn.1001-165x.2010.06.030.
[13]Karacan I, Aydin T, Sahin Z, et al. Facet angles in lumbar disc herniation: their relation to anthropometric features[J]. Spine (Phila Pa 1976), 2004, 29(10): 1132-1136. DOI: 10.1097/00007632-200405150-00016.
[14]Ishihara H, Matsui H, Osada R, et al. Facet joint asymmetry as a radiologic feature of lumbar intervertebral disc hernia tion in children and adolescents[J]. Spine (Phila Pa 1976), 1997, 22(17): 2001-2004. DOI: 10.1097/00007632-199709010-00012.
[15]Wang H, Zhou Y. Facet tropism: possible role in the pathology of lumbar disc herniation in adolescents[J]. J Neurosurg Pediatr, 2016, 18(1): 111-115. DOI: 10.3171/2015.7.PEDS15175.
[16]Grogan J, Nowicki BH, Schmidt TA, et al. Lumbar facet joint tropism does not accelerate degeneration of the facet joints[J]. AJNR Am J Neuroradiol, 1997, 18(7): 1325-1329. 

文章导航

/