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C0-C2 Cobb 角与颈椎间盘突出的相关性研究
Hits: 93   Download times: 14   Received:December 05, 2024    
作者Author单位UnitE-Mail
麦卓恒 MAI Zhuo-heng 广州中医药大学第八临床医学院, 广东 广州 510006 The Eighth Clinical School of Medicine, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510006, Guangdong, China  
古远莉 GU Yuan-li 广州中医药大学第八临床医学院, 广东 广州 510006 The Eighth Clinical School of Medicine, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510006, Guangdong, China  
王海铃 WANG Hai-ling 广州中医药大学第八临床医学院, 广东 广州 510006 The Eighth Clinical School of Medicine, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510006, Guangdong, China  
张丽英 ZHANG Li-ying 广州中医药大学第八临床医学院, 广东 广州 510006 The Eighth Clinical School of Medicine, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510006, Guangdong, China  
张盛强 ZHANG Sheng-qiang 佛山市中医院推拿科, 广东 佛山 528051 Department of Tuina, Foshan Hospital of Traditional Chinese Medicine, Foshan 528051, Guangdong, China fs82237451@126.com 
期刊信息:《中国骨伤》2025年38卷,第5期,第494-499页
DOI:10.12200/j.issn.1003-0034.20240645
基金项目:佛山市"十四五"中医重点专科建设项目(编号:佛卫函[2020]15号);佛山市医学科技攻关计划项目(编号:2220001004739)


目的:探讨颈椎间盘突出与C0-C2 Cobb角的关系。

方法:回顾性分析2020年至2024年301例颈椎间盘突出症患者的影像学资料,取301例患者C0-C2 Cobb角测量数值的中位值为界限,将颈椎间盘突出症患者分成C0-C2 Cobb角<28.50°组150例与C0-C2 Cobb角 ≥ 28.50°组151例。其中,C0-C2 Cobb角<28.50°组男53例,女97例,年龄23~76(57.32±12.55)岁,病程7~19(13.81±5.32)个月;C0-C2 Cobb角 ≥ 28.50°组男61例,女90例,年龄25~74(56.86±12.51)岁,病程8~18(14.13±5.56)个月。在颈椎侧位片上测量颈椎前凸角(C0-C2 Cobb角和C2-C7 Cobb角)、T1倾斜角(T1S)、颈椎矢状位轴向距离(C2-C7 SVA),分析C0-C2 Cobb角与颈椎间盘突出范围、突出位置、突出大小及其余参数的相关性。

结果:当C0-C2 Cobb角<28.50°时,颈椎间盘突出大小为(2.21±0.56) mm、C2-C7 Cobb角为(19.92±12.06)°、C2-C7 SVA为(1.10±1.20) mm,C0-C2 Cobb角 ≥ 28.50°时,突出大小为(2.38±0.60) mm、C2-C7 Cobb角为(12.01±13.09)°、C2-C7 SVA为(1.53±1.36) mm,差异有统计学意义(P<0.05)。在C0-C2 Cobb角<28.50°和C0-C2 Cobb角 ≥ 28.50°的两组患者间,单节段的C3,4、C4,5、C5,6、C6,7、C7T1椎间盘突出大小比较,差异有统计学意义(P<0.05);C0-C2 Cobb角与年龄(r=-0.135,P<0.05)、C2-C7 Cobb角(r=-0.382,P<0.01)、C2-C7 SVA(r=0.293,P<0.01)、突出大小(r=0.139,P<0.05)、C3,4(r=0.215,P<0.01)、C4,5(r=0.176,P<0.01)、C5,6(r=0.144,P<0.05)、C6,7(r=0.158,P<0.05)、C7T1(r=0.535,P<0.05)椎间盘突出大小相关。

结论:C0-C2 Cobb角与颈椎间盘突出大小呈正相关关系,C0-C2 Cobb角能反映颈椎间盘突出的程度;既往研究表明,C0-C2 Cobb角、C2-C7 Cobb角、C2-C7 SVA与颈伸肌群之间的生物力学改变可能是加速颈椎间盘突出的危险因素,这可能是C0-C2 Cobb角与颈椎间盘突出大小呈正相关性的机制之一。
[关键词]:Cobb角  颈椎  椎间盘突出  突出大小
 
Association relation of C0-C2 Cobb angle and cervical disc herniation
Abstract:

Objective Objective To investigate the relationship between cervical disc herniation and %CI Cobb angle.

Methods The clinical data of 301 patients with cervical disc herniation from 2020 to 2024 were retrospectively analyzed. The median value of C0-C2 Cobb angle measurements from 301 patients was used as the boundary,cervical disc herniation patients were divided into two groups,C0-C2 Cobb angle <28.50 group and 151 patients with C0-C2 Cobb angle ≥ 28.50 group. Among them,150 patients in C0-C2 Cobb angle <28.50 group included 53 males and 97 females,aged 23 to 76 (57.32±12.55) years,with a disease duration of 7 to 19 (13.81±5.32) months;the othor 151 patients with C0-C2 Cobb angle ≥ 28.50 group including 61 males and 90 females,aged 25 to 74 (56.86±12.51) years,with a disease duration of 8 to 18 (14.13±5.56) months. The cervical lordosis angle (C0-C2 Cobb angle and C2-C7 Cobb angle),T1 inclination slope (T1S) and cervical sagittal axial distance (C2-C7 SVA) were measured on the lateral cervical radiographs. The correlation between C0-C2 Cobb angle and cervical disc herniation range,protrusion position,average protrusion size and other parameters was analyzed.

Results When the C0-C2 Cobb angle<28.50 °,the average protrusion size was (2.21±0.56) mm,the C2-C7 Cobb angle was (19.92±12.06)° and the C2-C7 SVA was (1.10±1.20) mm. When the C0-C2 Cobb angle ≥ 28.50 °,the average protrusion size was (2.38±0.60) mm,the C2-C7 Cobb angle was (12.01±13.09) °,the C2-C7 SVA was (1.53±1.36) mm,and the difference was statistically significant (P<0.05). Between the two groups of patients with C0-C2 Cobb angle < 28.50 ° and C0-C2 Cobb angle ≥ 28.50 °,there were significant differences in the size of C3,4,C4,5,C5,6,C6,7,C7,T1 disc herniation in single segment (P<0.05). C0-C2 Cobb angle was correlated with age(r=-0.135,P<0.05),C2-C7 Cobb angle (r=-0.382,P<0.01),C2-C7 SVA (r=0.293,P<0.01),average protrusion size (r=0.139,P<0.05),and the size of C3,4 (r=0.215,P<0.01),C4,5 (r=0.176,P<0.01),C5,6 (r=0.144,P<0.05),C6,7 (r=0.158,P<0.05),C7T1 (r=0.535,P<0.05) disc herniation.

Conclusion There is a positive correlation between C0-C2 Cobb angle and the size of cervical disc herniation. C0-C2 Cobb angle can reflect the degree of cervical disc herniation. Previous studies have shown that the biomechanical changes between C0-C2 Cobb angle,C2-C7 Cobb angle,C2-C7 SVA and cervical extensor muscle group may be risk factors for accelerating cervical disc herniation and this may be one of the mechanisms that C0-C2 Cobb angle is positively correlated with the size of cervical disc herniation.
KEYWORDS:Cobb angle  Cervical vertebrae  Intervertebral disc herniation  Size of herniation
 
引用本文,请按以下格式著录参考文献:
中文格式:麦卓恒,古远莉,王海铃,张丽英,张盛强.C0-C2 Cobb 角与颈椎间盘突出的相关性研究[J].中国骨伤,2025,38(5):494~499
英文格式:MAI Zhuo-heng,GU Yuan-li,WANG Hai-ling,ZHANG Li-ying,ZHANG Sheng-qiang.Association relation of C0-C2 Cobb angle and cervical disc herniation[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(5):494~499
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