下颈椎关节突关节的影像学观测及其临床意义

目的:观测下颈椎关节突关节面的形态及其三维空间角度,探讨其临床意义。方法:选取60例正常人行颈椎CT检查,螺旋CT三维重建后在横轴面、矢状面、冠状面上观察颈椎关节突关节面形态特点,并测量关节面的曲度、关节突关节角。结果:横轴面,C3上关节面及C7的下关节面直面形多见。C3、C4、C5Ⅱ型关节面曲度比较无显著差异,C5～C7关节突关节面曲度逐渐变小(P<0.05)。C3-C4、C4-C5、C5-C6、C6-C7、C7-T1关节突关节面与矢状面的夹角分别为91.98°±9.92°、96.64°±9.01°、99.46°±7.66°、94.20°±8.72°、94.83°±10.88°,C4-C5、C5-C6夹角较大(P<0.05)。冠状面,C6/7节段椭圆形多见,C2/3、C3/4节段圆形多见。矢状面,下颈椎C3～C7关节突关节倾角分别为52.09°±6.28°、48.14°±4.75°、45.81°±4.07°、55.65°±4.15°、58.32°±5.77°,C3、C6、C7与C5关节突关节倾角之间差异显著(P<0.05)。结论:正常人下颈椎关节突关节形态在诸节段及横轴面、冠状面不尽相同。横轴面上,C3～C7的上关节面的方向逐渐从朝向正中矢状面转向外侧,渐渐与胸椎的小关节相适应,矢状面上,C3～C7的关节倾角均为锐角,且以C5为中心分布。

Helical CT three-dimensional reconstruction for inferior cervical zygapophyseal joint and its clinic meaning

Objective:To study the three-dimensional quantitative morphology as well as the orientation of cervical zygapophyseal joint and their clinical significances.Method:The cervical zygapophyseal joints of 60 normal volunteers were scanned using spiral CT and reconstructed three-dimensionally.The shapes,curvatures and angulations of these joints were observed and measured in the cross-sectional,sagittal and coronal planes respectively.Result:At the cross-sectional plane,the superior facet joint of C3 and the inferior facet joint of C7 presented with face-type frequently.The C-shape articular surfaces in C3,C4,C5 showed no statistic significance.The angles of the articular facet orientation at C3/4,C4/5,C5/6,C6/7 and C7/T1 were 91.98°±9.92°,96.64°±9.01°,99.46°±7.66°,94.20°±8.72° and 94.83°±10.88° respectively,with the angles of C4/5 and C5/6 significantly larger than others(P<0.05).At coronal plane,ellipsetype occured more frequently on C6/7,while roundtype occured more frequently on C2/3 and C3/4.At sagittal plane,the angulations from C3～C7 were 52.09°±6.28°,48.14°±4.75°,45.81°±4.07°,55.65°±4.15° and 58.32°±5.77° respectively,with the angles of C3,C6 and C7 significantly larger than C5(P<0.05).Conclusion:The cervical zygapophyseal joints differ in morphology.In the cross-sectional plane,the orientations of C3-C7 superior facet joint change from midline to lateral,and adapt to thoracic facet joint;while in sagittal plane,facet joint angles from C3-C7 are acute,and distribute on the center of C5.