退变性腰椎管狭窄症患者颈椎管的X线测量

目的研究退变性腰椎管狭窄症出现脊髓型颈椎病高发倾向的发病机制以及这两种疾病的内在联系。方法用前瞻性研究的方法,对行手术治疗的68例退变性腰椎管狭窄症患者,在其颈椎侧位x线片上进行颈椎管测量,并计算颈椎椎管矢状径比值。其中男性23例,女性45例,年龄22～69岁,平均年龄50．0岁。将测量的411例正常人颈椎侧位x线片椎管矢状径结果作为对照组,两组进行比较。结果退变性腰椎管狭窄症患者组其颈椎椎管矢状径比值平均值男性为0．781,女性为0．807;而正常对照组其颈椎椎管矢状径比值平均值男性为0．874,女性为0．968。两组相比,无论男女,退变性腰椎管狭窄症患者组其颈椎椎管矢状径比值为C3～C7节段均低于其相应的正常对照组（均P〈0．05）。退变性腰椎管狭窄症患者组有27．9％出现发育性颈椎管狭窄,高于正常人中可以有10％出现发育性颈椎管狭窄的比例。结论与正常人群相比,退变性腰椎管狭窄症患者更加易于出现发育性颈椎管狭窄。

X-ray measurement of cervical spinal canal in patients with degenerative lumbar spinal canal stenosis

Objective To investigate the mechanism of high occurrence of cervical spondylotic myelopathy in the patients with degenerative lumbar spinal stenosis and the relationship between these two diseases.Methods Lateral radiographic plain films were made on 68 cases with degenerative lumbar spine stenosis 23 males and 45 females,aged 50.0(22-69).The sagittal diameter of the spinal canal(a)was obtained by measuring the shortest distance between the middle point of the posterior margin of the cervical spinal body to the connective cortex of spinal process and vertebral lamina,the distance between the middle points of anterior and posterior margins of vertebral body was measured as the sagittal diameter of vertebral body(b),and the ratio of these sagittal diameters was calculated for the vertebral bones C3-C7.The data of sagittal diameters of cervical spinal canal and cervical vertebral body and relevant a/b ratio value obtained from 411 healthy subjects ware used as normal controls to be compared with those of the degenerative lumbar spine stenosis patients.Results In the group of degenerative lumbar spinal stenosis the average value of a/b ratio of C3-C7 were 0.781 in the males and was 0.807 in females respectively,both significantly lower than those of the healthy control group(0.874 in the males and 0.968 in the females respectively,both P<0.05).The incidence rate of developmental cervical spinal stenosis in the group of degenerative lumbar spine stenosis was 27.9%,and that in healthy objective was 10%.Conclusion Compared to the healthy objectives,the patients with degenerative lumbar spinal stenosis is easier to be inclined to the developmental cervical spinal stenosis.