下颈椎关节突关节的影像学观测及其临床意义

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

中文关键词:  颈椎  关节突关节角  小关节面  三维测量

英文关键词:Cervical spine  Zygapophyseal joints  Articular facets  Three-dimensional measurement

中文摘要:

  【摘要】 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。

英文摘要:

  【Abstract】 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.