颈椎生理曲度异常对颈椎病发病作用的病例对照研究

目的:探讨颈椎生理曲度异常对颈椎病发病的作用,为颈椎病的临床诊治提供思路。方法:研究设颈椎病和无颈椎病两组,其中颈椎病组(来源于2006年3月至2008年12月曙光医院骨伤科门诊患者)333例,男119例,女214例;平均年龄(48.11±12.21)岁。无颈椎病组受试者73例(来源于上海中医药大学在校大学生、曙光医院研究生及进修生、部分社区人员),男18例,女55例;平均年龄(45.99±11.47)岁。对两组受试者的颈椎侧位X线片进行颈椎生理曲度观测,比较两组中颈椎生理曲度异常的发生率的差异性,并对两组颈椎生理曲度异常改变的临床特点进行分析。结果:与无颈椎病组相比,颈椎病组患者颈椎生理曲度异常发生率高达95.50%(318/333),二者之间具有统计学差异(P=0.0000.01);且颈椎病组颈椎生理曲度异常形式较复杂和多样化,其中颈椎生理曲度减小占23.12%(77/333),变直占40.84%(136/333),增大占0.60%(2/333),反弓占12.01%(40/333),S形占4.20%(14/333),反S形占2.70%(9/333),上曲下直(以C4为分界点)占4.50%(15/333),上直下曲(以C4为分界点)占7.51%(25/333)。结论:颈椎生理曲度异常是各型颈椎病早期X线征象,且颈椎生理曲度异常形式较复杂和多样化,临床不能笼统称之为"颈椎生理曲度异常",而应重视颈椎生理曲度异常分型的研究,这将对颈椎病的临床诊治具有指导意义。

Case control study on the association between abnormality curvature of cervical spine and pathogenesy of cervical spondylosis

Objective: To explore the relationship between the abnormality curvature of cervical spine and pathogenesy of cervical spondylosis,in order to provide a new way in diagnosis of cervical spondylosis. Methods: There were two groups in the study,which were non-cervical spondylosis group(with heath adults)and cervical spondylosis group. From March 2006 to December 2008,333 patients(out-patients in department of orthopaedics of Shuguang hospital) in cervical spondylosis group,which were 119 males,214 females with an average age of(48.11±12.21) years. There were 73 subjects in non-cervical spondylosis group,which was 18 males,55 females with an average age of (45.99±11.47) years. Based on the lateral view X-ray pictures of cervical spine,the abnormality curvature and character of cervical spine were studied in two groups. Results: The incidence rate in abnormality curvature of cervical spine in cervical spondylosis group(achieved to 95.50%) was more than that of non-cervical spondylosis group,there was significant difference between two groups(P=0.000<0.01). Furthermore,the patterns of the abnormality curvature of cervical spine in cervical spondylosis group was complicated and variegated,of which physiological curvature diminished had 23.12%(77 cases),turn straight had 40.84%(136 cases),increased had 0.60% (2 cases),recurved had 12.01% (40 cases),S shape had 4.20%(14 cases),contra-S shape had 2.70% (9 cases),upper flex and lower straight had 4.50% (15 cases),upper straight and lower flex had 7.51% (25 cases). Conclusion: The abnormality curvature of cervical spine may be an X-ray diagnostic indication to the cervical spondylosis,which is complicated and variegated. It will provide the guidance for the diagnosis and treatment of cervical spondylosis.