颈椎持续前屈与椎间盘退行性病变及生理曲度异常的相关性分析

目的:探讨椎间盘退行性病变与前凸生理曲度异常改变的病理机制及颈椎持续前屈与两者的相关性,为颈椎退行性病变的早期预防和治疗提供客观依据。方法:随机选取2012年3~10月间经颈椎中立位侧位片诊断前凸生理曲度异常的患者146例,均在1周内行常规MRI扫描,并按年龄分为A组(16~30岁),B组(31~40岁),C组(41~55岁),分析不同年龄组前凸生理曲度改变时相应椎间盘的MRI表现。结果:颈椎前凸生理曲度异常改变时,其大部分椎间盘均已变性,变性的部分椎间盘存在不同程度的膨出或突出。年龄较轻,病程越短,椎间盘变性相对较少(A组与B组比较,P0.01,差异有统计学意义);随年龄增长,变性椎间盘增多,但在一定范围内无明显差异(B组与C组比较P0.05,差异无统计学意义)。椎间盘变性后,多数椎间盘会有不同程度的膨出或突出,不同年龄组膨出和突出分布不全相同,其中A组与B组及C组比较,P0.05,差异无统计学意义,B组与C组比较,P0.01,差异有统计学意义。结论:颈椎持续的前屈活动是椎间盘退变的重要致病原因,而椎间盘退变则是颈椎生理曲度最终变直、消失或后凸异常改变的病理基础;年龄越小,变性椎间盘越少。

The imaging correlation between the cervical vertebra proneness with degeneration of the intervertebral disc and abnormal physiological curvature

Objective：To investigate pathomechanism and relationship between abnormal cervical proneness with intervertebral disc degenerative diseases and the abnormal changes of lordosis physiological curvature. And to provides objective basis for early prevention and treatment of cervical spondylosis. Methods：A total of 146 patients with lordosis physiological curvature anomaly diagnosised by a neutral lateral radiographs of cervix were selected from March 2012 to October 2012. All patients were adept conventional MRI scanning in a week. According to the age,all patients were divided into three groups （A,B, and C）. We ana- lyzed MRI performance of the corresponding intervertebral disc when lordosis physiological curvature changed in different age groups. Results：When cervical lordosis physiological abnormal curvature changed, most of the intervertebral discs had been de- natureed. Part of the intervertebral disc degeneration had disc bulge or herniated in different degree. The intervertebral disc de- generation was relatively less in the younger age and the shorter course of disease （group A compared to group B,P%0.01, there was statistical significance）. Along with the age growth, the degenerative intervertebral disc increased. But in a certain range （group B compared to group C,P~O. 05 ,no statistical significance） ,there were no obvious difference. The mest of the in- tervertebral disc had different degrees of bulging or protrusion after intervertebral disc degeneration. The distribution of disc bulge or protrusion was not all the same in different age groups（group A compared to group B and group C,P~O. 05 ,no statis tieal significance; group B compared to group C,P＇~0.01 ,there was statistical significance）. Conclusion：The continuous and ab- normal pronerness activity for cervical vertebra is the important cause of the disc degeneration. And the intervertebral disc de- generation is the pathological basis that cervical physiological curvature finally straightened, disappear, or kyphosis abnormal changes. The smaller the age,the less intervertebral disc degeneration.