新的枕颈中立位影像学参数：枕颈倾斜度

目的通过枕颈倾斜度(occipitocervical inclination,OCI)与枕颈矢状位各参数间的相关性研究,评价枕颈倾斜度的临床应用价值。方法通过北京大学首钢医院骨科门诊招募无颈肩部症状的416名志愿者,其中男性177例,女性239例;年龄18-85岁,平均(49.44±14.54)岁。运用PACS系统在标准侧位颈椎X线片上测量OCI、枕颈角(occipitocervical angle,OCA)、颈椎前凸角(cervical lordosis,CL)、C2-7矢状位平衡(C2-7sagittal vertical axis,C2-7SVA)、T1椎体倾斜角(T1slope,T1S)等矢状位参数,运用SPSS 20.0进行统计分析。结果 OCI、OCA、CL、T1S、SVA分别为(111.14±8.68)°、(22.97±8.02)°、(17.02±11.32)°、(26.47±6.90)°、(19.08±9.48)mm,其中OCA、CL、T1S男女性别之间比较差异有统计学意义(P<0.05);OCI与OCA、SVA之间的Pearson相关系数r分别为0.623(P<0.001)、0.433(P<0.001)。结论枕颈倾斜度是一个测量简便、稳定可靠的枕颈部矢状位参数;我们推荐中国人正常的OCI值为110°,可为术中快速有效的确定枕颈部中立位以及评价颈椎矢状位平衡提供临床参考。

New Radiographic Parameter of Neutral Occipitocervical Position:Occipitocervical Inclination

Objective To evaluate the clinical application value of occipitocervical inclination(OCI)by Pearson correlation analysis of OCI and occipitocervical parameters.Methods A total of 416 outpatients without neck and shoulder symptoms were enrolled,including 177 males and 239 females,with an average age of(49.44±14.54)years(18-85 years).Occipitocervical parameters were measured on standard lateral cervical X-ray films by PACS system,including OCI,occipitocervical angle(OCA),cervical lordosis(CL),and C2-7 sagittal vertical axis(C2-7 SVA),T1 slope(T1 S).SPSS20.0 was used in statistical analysis.Results OCI,OCA,CL,T1 S,SVA were(111.14±8.68)°,(22.97±8.02)°,(17.02±11.32)°,(26.47±6.90)°,(19.08±9.48)mm,respectively.There was a significant difference between genders of OCA,CL,T1 S(P<0.05).The Pearson correlation coefficient(r)between OCI and OCA,SVA were 0.623(P<0.001),0.433(P<0.001),respectively.Conclusion Occipitocervical(OCI)as occipitocervical sagittal parameter is a simple,stable and reliable.We recommend that the a normal OCI of Chinese as 110°,which could be used to determine the neutral occipitocervical position quickly and effectively and evaluate the cervical sagittal balance.