[1]邓真,王玉鹏,赵璐璐,等.颈椎病患者项韧带钙化与颈椎曲度的相关性分析[J].中国中医骨伤科杂志,2023,31(01):19-24.
 DENG Zhen,WANG Yupeng,ZHAO Lulu,et al.Correlation Analysis between the Ossification of Nuchal Ligament and Cervical Curvature in Patients with Cervical Spondylosis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(01):19-24.
点击复制

颈椎病患者项韧带钙化与颈椎曲度的相关性分析()
分享到:

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年01期
页码:
19-24
栏目:
临床研究
出版日期:
2023-01-15

文章信息/Info

Title:
Correlation Analysis between the Ossification of Nuchal Ligament and Cervical Curvature in Patients with Cervical Spondylosis
文章编号:
1005-0205(2023)01-0019-06
作者:
邓真12王玉鹏3赵璐璐3王辉昊23商海滨1廉由之1李国中1△詹红生23△
1上海市宝山区中西医结合医院/上海中医药大学附属宝山医院(上海,201999) 2詹红生上海市名中医工作室 3上海中医药大学附属曙光医院
Author(s):
DENG Zhen12WANG Yupeng3ZHAO Lulu3WANG Huihao23SHANG Haibin1LIAN Youzhi1LI Guozhong1△ZHAN Hongsheng23△
1Shanghai Baoshan Hosptial of Integrated Traditional Chinese and Western Medicine,Shanghai 201999,China; 2Zhan Hongsheng Studio of Academic Experience of Shanghai Famous Doctors in Traditional Chinese Medicine,Shanghai 201203,China; 3Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China.
关键词:
项韧带钙化 颈椎曲度 颈椎病 颈椎间盘退变
Keywords:
ossification of nuchal ligament cervical curvature cervical spondylosis cervical disc degeneration
分类号:
R681.5
文献标志码:
A
摘要:
目的:探讨颈椎病患者中项韧带钙化与颈椎曲度间的相关性。方法:回顾性分析290例颈椎病患者临床和影像学资料,根据有无项韧带钙化分为2组,测量项韧带钙化的程度,比较2组患者性别、年龄、体重指数(BMI)、病程、颈椎曲度、椎间隙高度丢失评分、疼痛数字评分量表(NRS)、伴随症状之间的差异; 根据C2~C7 Cobb角将颈椎曲度分为前凸型、直型和后凸型3种。分析项韧带钙化及程度与上述因素之间的相关性,找出影响项韧带钙化的危险因素。结果:290例颈椎病患者中,项韧带钙化发生率为61.38%,男性发病率为女性的1.62倍,共229个颈椎节段发生了项韧带钙化,依次为C5/6(39.3%)、C4/5(38.0%)、C3/4(15.3%)、C6/7(5.7%)和C2/3(1.7%)。项韧带钙化组患者的年龄、C2~C7 Cobb角、Jackson应力曲线、椎间隙高度丢失评分与无项韧带钙化组比较,差异均有统计学意义(P<0.05)。项韧带钙化与直型颈椎曲度呈强正相关性,与年龄、性别、椎间隙高度丢失评分呈中度正相关性,与疼痛数字评分量表评分呈轻度正相关性,与后凸型颈椎呈轻度负相关性,项韧带钙化程度与各因素间无相关性。直型颈椎曲度是项韧带钙化最重要的危险因素,其次是椎间隙高度丢失,疼痛数字评分量表评分和年龄对项韧带钙化也有影响。结论:项韧带钙化与直型颈椎高度相关,但钙化程度与颈椎曲度类型无关,项韧带钙化的发生可预测患者存在椎间隙高度丢失相关性疾病和较重的疼痛程度。
Abstract:
Objective:To investigate the correlation between the ossification of nuchal ligament(ONL)and different type of cervical curvature in patients with cervical spondylosis.Methods:The clinical and imaging data of 290 patients with cervical spondylosis were analyzed retrospectively.They were divided into two groups according to the presence or absence of ONL.The degree of ONL was measured.The differences between the two groups in gender,age,body mass index(BMI),course of disease,cervical curvature,intervertebral space height loss score,numerical rating scale(NRS)scores and accompanying symptoms were compared.The cervical curvature was divided into three types:lordosis types,straight types and kyphosis types according to the C2 to C7 Cobb angle.The correlation between ONL and the above factors was analyzed to find out the risk factors affecting ONL.Results:Among the 290 cases of cervical spondylosis,the incidence of ONL was 61.38%,and the incidence rate of male was 1.62 times higher than that of female.There were 229 ONL segments,which were C5/6(39.3%),C4/5(38%),C3/4(15.3%),C6/7(5.7%)and C2/3(1.7%)respectively.There were significant differences in age,C2 to C7 Cobb angle,Jackson stress curve and intervertebral space height loss score between the ONL group and non-ONL group(P<0.05).There was a strong positive correlation between ONL and straight cervical curvature,a moderate positive correlation with age and intervertebral space height loss,a slight positive correlation with NRS and a slight negative correlation with kyphosis curvature.The degree of ONL had no correlation with all factors.Straight cervical curvature was the most important risk factor for ONL,followed by the loss of intervertebral space height.NRS and age are also risk factors for ONL.Conclusion:ONL is highly related to straight cervical curvature,but the degree of calcification has no relationship with the type of cervical curvature.The occurrence of ONL can predict that patients have diseases related to intervertebral space height loss and server pain.

参考文献/References:

[1] 罗杰,魏戌,李家金.项韧带钙化的临床意义及生物力学探讨[J].中国骨伤,2010,4(23):305-307.
[2] SHINGYOUCHI Y,NAGAHAMA A,NIIDA M.Ligamentous ossification of the cervical spine in the late middle-aged Japanese men.Its relation to body mass index and glucose metabolism[J].Spine,1996,21(21):2474-2478.
[3] SCAPINELLI R.Sesamoid bones in the ligamentum nuchae of man[J].J Anat,1963,97(Pt3):417-422.
[4] YU M,ZHAO WK,LI M,et al.Analysis of cervical and global spine alignment under Roussouly sagittal classification in Chinese cervical spondylotic patients and asymptomatic subjects[J].Eur Spine J,2015,24(6):1265-1273.
[5] YOON S Y,MOON H I,LEE S C,et al.Association between cervical lordotic curvature and cervical muscle cross-sectional area in patients with loss of cervical lordosis[J].Clin Anat,2018,31(5):710-715.
[6] KIM M S,PARK H J,LEE S Y,et al.Association between ossification of the posterior longitudinal ligament and ossification of the nuchal ligament in the cervical spine[J].PLoS ONE,2019,14(11):1-9.
[7] ZHANG B,CHEN G,GAO X,et al.Potential link between ossification of nuchal ligament and the risk of cervical ossification of posterior longitudinal ligament:evidence and clinical implication from a meta-analysis of 8429 participants[J].Orthopaedic Surgery,2021,13(3):1055-1066.
[8] WALRAEVENS J,LIU B,SLOTEN J V,et al.Qualitative and quantitative assessment of degeneration of cervical intervertebral discs and facet joints[J].European Spine Journal,2009,18(3):358-369.
[9] GROB D,FRAUENFELDER H,MANNION A F.The association between cervical spine curvature and neck pain[J].European Spine Journal,2007,16(10):1741-1743.
[10] WANG H,ZOU F,JIANG J,et al.Analysis of radiography findings of ossification of nuchal ligament of cervical spine in patients with cervical spondylosis[J].Spine,2014,39(1):7-11.
[11] IZAWA K.Comparative roentgenographical study on the incidence of ossification of the posterior longitudinal ligament and other degenerative changes of the cervical spine among Japanese,Koreans,Americans and Germans(author's transl)[J].Nihon Seikeigeka Gakkai Zasshi,1980,54(5):461-474.
[12] KATAYAMA H,NANJO T,SAITO M,et al.Radiological analysis of the ossifications of the nuchal ligaments[J].Rinsho Hoshasen,1982,27(1):91-95.
[13] SEONG H Y,LEE M K,JEON S R,et al.Prognostic factor analysis for management of chronic neck pain:can we predict the severity of neck pain with lateral cervical curvature?[J].J Korean Neurosurg Soc,2017,60(4):456-464.
[14] GORE D R.Roentgenographic findings in the cervical spine in asymptomatic persons:a ten-year follow-up[J].Spine,2001,26(22):2463-2466.
[15] MARCHIORI D M,HENDERSON C N.A cross-sectional study correlating cervical radiographic degenerative findings to pain and disability[J].Spine,1996,21(23):2747-275.
[16] 任龙喜,何玉宝,郭函,等.颈部疼痛程度与颈椎曲度相关性的临床观察[J].中国脊柱脊髓杂志,2011,21(9):750-753.
[17] 陆炜强,袁峰,陈加成.项韧带骨化与颈椎曲度及节段稳定的影像学分析[J].中国组织工程研究,2020,24(12):1923-1928.
[18] TAKESHITA K,PETERSON E T,BYLSKI-AUSTROW D,et al.The nuchal ligament restrains cervical spine flexion[J].Spine,2004,29(18):388-393.
[19] SHEDID D,BENZEL E C.Cervical spondylosis anatomy:Pathophysiology and biomechanics[J].Neurosurgery,2007,60(1):7-13.
[20] LIU B,LIU Z,VANHOOF T,et al.Kinematic study of the relation between the instantaneous center of rotation and degenerative changes in the cervical intervertebral disc[J].Eur Spine J,2014,23(11):2307-2313.
[21] BO Y,ZHIWEI W,YIN Z,et al.Radiographic features and correlation analysis of location of ossification in patients with cervical ossification of the posterior longitudinal ligament combined with ossification of the nuchal ligament[J].World Neurosurg,2018,116:929-933.
[22] 戴力扬.颈椎间盘退行性改变与颈椎不稳[J].中华外科杂志,1999,37(3):180-182.
[23] ROBINSON R A,AFEICHE N,DUNN E J,et al.Cervical spondylotic myelopathy:etiology and treatment concepts[J].Spine,1977,2(2):831-837.
[24] KIM K W,OH Y M.Increased prevalence of ossification of posterior longitudinal ligament and increased bone mineral density in patients with ossification of nuchal ligament[J].Korean J Spine,2016,13(3):139-143.
[25] 张黎,李德光,索上喻,等.项韧带钙化的中医治疗现状[J].云南中医中药杂志,2018,12(39):81-83.
[26] 金生飞.锋勾针治疗项韧带损伤87例[J].中医外治杂志,2009,18(3):27.
[27] 韩安,杨英昕.小针刀治疗项韧带钙化的临床效果观察[J].按摩与康复医学,2018,9(4):29-30.
[28] 张秉贤,林孙枝,黄林升,等.药物局部注射配合小针刀治疗项韧带钙化80例[J].国医论坛,2011,26(3):27.
[29] TSAI Y L,WENG M C,CHEN T W,et al.Correlation between the ossification of nuchal ligament and clinical cervical disorders[J].Kaohsiung Journal of Medical Sciences,2012,28(10):538-544.
[30] SHEDID D,BENZEL E C.Cervical spondylosis anatomy:pathophysiology and biomechanics[J].Neurosurgery,2007,60(S1):7-13.
[31] FERGUSON R J,CAPLAN L R.Cervical spondylitic myelopathy[J].Neurologic Clinics,1985,3(2):373-382.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81804114,81973871)
上海市卫健委临床行业面上项目(202240188)
上海市人才发展资金资助项目(2019101)
上海市卫计委詹红生上海市名老中医学术经验研究工作室建设项目(SHGS-2017025,SZYMYGZS4013)
上海市中医诊疗模式创新试点建设项目(ZY2018-2002-FWTX-6003)
上海中医药大学后备卓越中医人才项目(30)
上海高水平地方高校创新团队(慢性筋骨病损研究与转化)
通信作者 E-mail:shgsyjs@139.com(詹红生)
15000822918@163.com(李国中)
更新日期/Last Update: 2023-01-10