青少年特发性颈椎后凸畸形的影像学特征及其临床指导意义

Radiographic analysis and clinical significance of adolescent idiopathic cervical kyphosis

中文关键词:  颈椎  后凸  畸形  青少年  特发性  影像学

英文关键词:Cervical spine  Kyphosis  Deformity  Adolescent  Idiopathic  Image

中文摘要:

  【摘要】 目的：分析青少年特发性颈椎后凸畸形患者的影像学特征，探讨评价后凸曲度的可靠方法。方法：对23例青少年特发性颈椎后凸畸形患者的影像学资料进行分析，在矢状位X线片上测量C2～C7的后切线角及Cobb角、后凸节段后切线角及Cobb角、后凸累及椎体数、后凸顶点位置，计算颈椎曲度指数（CI）及后凸指数（KI），并进行相关性分析。结果：本组后凸节段C2～C5 11例，C2～C6 5例，C3～C6 7例，后凸平均累及椎体4．2个（平均累及3．2个椎间隙）；后凸顶点均位于椎体的后上缘，位于C4 16例（69．57%），C5 7例（30．43%）；C2～C7后切线角9．8°～75．1°，平均37．1°±16．7°；C2～C7的Cobb角为4．7°～68．3°，平均35．6°±14．5°；后凸节段后切线角19．8°～120．6°，平均54．8°±23．9°；后凸节段Cobb角21．8°～96．3°，平均53．7°±19．7°；颈椎曲度指数（CI）8．6～79．8，平均37．7±20．5；后凸指数（KI）15．2～141．9，平均53．0±29．1。统计学分析显示，后凸指数与后凸角度呈高度正相关。结论：青少年特发性颈椎后凸畸形的后凸顶点位于椎体的后上缘，后凸范围仅累及部分颈椎节段，后凸节段的后凸指数可准确地反映后凸畸形的严重程度。

英文摘要:

  【Abstract】 Objective：To investigate the radiographic characteristics and clinical significance of adolescent idiopathic cervical kyphosis and the reliability for evaluating cervical kyphosis．Method：Twenty-three adolescent patients with idiopathic cervical kyphosis were collected in this study．The causes of the disease remained unknown．The Cobb angle of kyphosis，posterior tangent angle of each segment，levels resulted in kyphosis and the apex of the kyphosis were measured on lateral radiographs．Kyphosis index（KI） and curvature index（CI） which were included were used to evaluate the severity of kyphosis．Result：Eleven（47．8%） patients had kyphosis level at C2-5，five（21．7%） at C2-6，and seven（30．4%） at C3-6．The mean vertebral number in kyphosis was 4．2（mean，3．2 levels）．The apex of the kyphosis was sited at C4（69．57%） in 16 patients and C5（30．43%） in 7 patients．Global Cobb angles（C2-C7） ranged from 4．7° to 68．3°（mean，35．6°±14．5°），and posterior tangent angle ranged from 9．8° to 75．1°（mean，37．1°±16．7°）．The Cobb angles of kyphosis ranged from 21．8° to 96．3°（mean，53．7°±19．7°） in two-line Cobb method，and 19．8° to 120．6°（mean，54．8°±23．9°） in Harrison posterior tangent method．CI ranged from 8．6 to 79．8（mean，37．7±20．5） and KI ranged from 15．2 to 141．9（mean，53．0±29．1），which showed significant positive correlation between KI and kyphosis angle．Conclusion：In adolescent idiopathic cervical kyphosis，the apex of kyphosis locates at the posterosuperior edge of vertebrae，and only part of vertebrae are involved.KI can accurately depict the severity of cervical kyphosis．