| 椎动脉型颈椎病与神经根型颈椎病X线片表现的比较分析 |
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投稿时间：2014-01-08
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| 作者 | Author | 单位 | Address | E-Mail |
| 冯敏山 |
FENG Min-shan |
中国中医科学院望京医院脊柱二科, 北京 100102 |
The Second Department of Spinal Surgery, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
fengminshan@hotmail.com |
| 高景华 |
GAO Jing-hua |
中国中医科学院望京医院脊柱二科, 北京 100102 |
The Second Department of Spinal Surgery, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 朱立国 |
ZHU Li-guo |
中国中医科学院望京医院脊柱二科, 北京 100102 |
The Second Department of Spinal Surgery, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 马子龙 |
MA Zi-long |
中国中医科学院望京医院脊柱二科, 北京 100102 |
The Second Department of Spinal Surgery, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 高春雨 |
GAO Chun-yu |
中国中医科学院望京医院脊柱二科, 北京 100102 |
The Second Department of Spinal Surgery, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 丁洪磊 |
DING Hong-lei |
中国中医科学院望京医院脊柱二科, 北京 100102 |
The Second Department of Spinal Surgery, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 期刊信息：《中国骨伤》2015年，第28卷，第4期，第330-334页 |
| DOI：10.3969/j.issn.1003-0034.2015.04.009 |
| 基金项目: |
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中文摘要:
目的:提高椎动脉型颈椎病的X线片诊断水平。
方法:将2011年1月至2012年11月收集的60例椎动脉型颈椎病(VCS)及60例神经根型颈椎病(NCS)患者[(年龄25～65岁,平均(48.4±12.3)岁,男36例,女84例)]的颈椎侧位及功能位X线片进行测量分析,测量指标包括颈椎曲度、寰枕关节间角、寰枢关节间角、C2/C3间角及下颈椎失稳情况及分布节段,通过数据分析,比较两组间差异;并结合椎动脉型颈椎病患者的临床表现,进一步分析椎动脉型颈椎病X线片的影像学特征。
结果:在前屈位X线片中,两组的颈椎曲度比较,差异有统计学意义(P<0.05);寰枕关节间角的后伸活动度两组间比较,差异有统计学意义(P<0.01);在侧位X线片中,两组的寰枢关节间角比较,差异有统计学意义(P<0.05).寰枢关节间角的前屈活动度两组间比较,差异有统计学意义(P<0.05).C2/C3间角的组间比较,差异无统计学意义;两组的下颈椎失稳情况及节段分布的比较,差异均无统计学意义。VCS组的临床表现中,头晕程度以轻中度为主,颈部屈伸活动诱发头晕最常见,头晕多伴有头痛症状,压痛部位多集中在上颈段。
结论:X线片征象及临床表现均提示VCS多伴随上颈段结构或功能的异常。临床上,诊断VCS时应重视对功能位X线片枕颈部前屈活动的观察。 |
| 【关键词】颈椎病 放射摄影术 诊断 |
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| Analysis of X-ray signs of cervical spondylosis between vertebral artery type and radiculopathy |
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ABSTRACT
Objective:To improve the X-ray diagnosis of cervical spondylosis of vertebral artery type(VCS).
Methods:A blinded design research. The X-ray signs both 60 patients with VCS and 60 patients with cervical spondylotic radiculopathy were collected from January 2011 to November 2012. There were 36 males and 84 females, aged from 25 to 65 years old with an average of (48.4±12.3) years old. Cervical curvature, atlanto-occipital joint angle, atlanto-axial joint angle, C2/C3 joint angle and lower cervical instability condition and segmental distribution were measured and recorded by X-rays. These data were analyzed and compared between the two groups after unblended. Combined with clinical manifestations, the X-ray imaging features of VCS were further analyzed.
Results:There was significant difference in cervical curvature between two groups in anteflexion X-ray films (P<0.05). There was significant difference in extension degree of atlanto-occipital joint angle between two groups (P<0.01). There was significant difference in atlanto-axial joint angle between two groups in lateral X-ray films (P<0.05). There was significant difference in anteflexion degree of atlanto-axial joint angle between two groups(P<0.05). There was no significant difference in C2/C3 joint angle between two groups. There was no significant difference in the lower cervical instability condition and segmental distribution between two groups. In VCS group, the mild and moderate dizziness was main symptom, flexion and extension activities of neck was most common cause in the dizziness;and always accompanied with headache;tenderness mostly concentrated in the upper cervical area.
Conclusion:Both X-ray signs and clinical manifestations can prompt the abnormalities of the upper cervical structure or function in patients with VCS. Anteflexion activities of neck observed by functional position of X-ray films should be emphasized in diagnosis of VCS. |
| KEY WORDS Cervical spondylosis Radiography Diagnosis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 冯敏山,高景华,朱立国,马子龙,高春雨,丁洪磊.椎动脉型颈椎病与神经根型颈椎病X线片表现的比较分析[J].中国骨伤,2015,28(4):330~334 |
| 英文格式: | FENG Min-shan,GAO Jing-hua,ZHU Li-guo,MA Zi-long,GAO Chun-yu,DING Hong-lei.Analysis of X-ray signs of cervical spondylosis between vertebral artery type and radiculopathy[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(4):330~334 |
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