儿童及青少年颈椎生理弯曲相关指标测量及临床意义

doi:10.13418/j.issn.1001-165x.2023.6.08

中国临床解剖学杂志 ›› 2023, Vol. 41 ›› Issue (6): 675-679.doi: 10.13418/j.issn.1001-165x.2023.6.08

儿童及青少年颈椎生理弯曲相关指标测量及临床意义

李琨^1#，张博然^2#，张宇²，韩可铭²，冯杰²，吴思瑶³，苏欣³，
苏娜³，王超群⁴，张少杰¹，李志军¹*，王星¹*

内蒙古医科大学 1.基础医学院人体解剖学教研室（数字医学中心）； 2.第一临床医学院； 3.鄂尔多斯临床医学院；
4.附属医院影像中心，呼和浩特 010110

收稿日期:2022-11-12 出版日期:2023-11-25 发布日期:2023-12-25
通讯作者: 王星，副教授，硕士生导师，E-mail：wangxing197911@163.com；李志军，教授，博士生导师，E-mail：13904717040@qq.com
作者简介:李琨（1988-），女，硕士，讲师，研究方向：儿童脊柱数字化解剖，E-mail：782140893@qq.com；并列第一作者: 张博然（2001-），女，本科生，研究方向：儿童脊柱数字化解剖研究，E-mail：1134504088@qq.com
基金资助:
国家自然科学基金资助项目（81860383，81860382）；内蒙古自治区自然科学基金项目（2020LH08021，2022QN03002，2020MS03061）；内蒙古自治区高等学校青年科技英才支持计划资助（NJYT22009）；内蒙古自治区科技计划项目（2019GG158）；内蒙古医科大学青年基金项目（YKD2020QNCX055）；内蒙古医科大学英才培育项目（YCPY2022019，YCPY2022051）；内蒙古医科大学大学生创新创业项目（202110132025，202210132031，202210132011）；内蒙古医科大学科研重点项目（YKD2021ZD011，YKD2022ZD007）；内蒙古自治区卫生健康委医疗卫生科技计划项目（202201217）

Measurement and clinical significance of cervical spine physiological curvature in children and adolescents

Li Kun^1#, Zhang Boran^2#, Zhang Yu², Han Keming², Feng Jie²,Wu Siyao³, Su Xin³, Su Na³, Wang Chaoqun⁴, Zhang Shaojie¹, Li Zhijun¹*, Wang Xing¹*

1. Department of Human Anatomy, School of Basic Medical Sciences, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia, China; 2. First School of Clinical Medicine, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia, China; 3. Ordos School of Clinical Medicine, I.M.M.U, Hohhot 010110, Inner Mongolia, China; 4. Center of Imaging, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia, China

Received:2022-11-12 Online:2023-11-25 Published:2023-12-25

摘要/Abstract

摘要： 目的基于CT测量儿童及青少年颈椎曲度的相关基础参数，分析其临床意义。方法收集到364例CT影像资料，以性别分组后，又按年龄分为1~3岁、4~6岁、7~9岁、10~12岁、13~15岁、16~18岁各6组。将扫描的颈椎断层影像原始数据以DICOM格式存贮，并导入Mimics 16.0，采用基于距离（Borden氏、颈椎曲度指数、椎体质心）和基于角度（C1~C7 Cobb角、C2~C7 Cobb角、Harrison氏）共6种测量方法分别测量儿童及青少年的颈椎曲度，对测量结果进行统计分析。结果 Borden氏与椎体质心测量法测量值显示13~15岁组与前4组均存在统计学差异（P<0.05）；C1~C7 Cobb角测量法测量值显示16~18岁组与前5组均存在统计学差异（P<0.05）；Harrison氏与椎体质心测量法测量值显示4~18岁之间的5组都与1~3岁组存在统计学差异（P<0.05）；性别间比较各指标无显著性差异；基于角度的曲度测量方法组内相关系数一致性较差，但各指标间存在显著性差异（P<0.05）。结论颈椎曲度的测量方法较多，每个指标具有各自优势，临床可根据研究对象和研究内容采取不同的测量方法，为儿童及青少年颈椎曲度的早期诊断、预防及治疗提供理论和技术支持。

关键词: 颈椎曲度； , , 儿童； , , 青少年； , , CT； , , Cobb角； , , Borden法

Abstract: Objective To analyze the clinical significance of children and adolescents cervical curvature based on the CT measurement of related basic parameters. Methods The collected CT imaging data of 364 patients were divided into 6 groups by gender and age: 1~3 years old group, 4~6 years old group, 7~9 years old group, 10~12 years old group, 13~15 years old group, 16~18 years old group. The original cervical spine tomography data were stored in DICOM format and imported into Mimics 16.0. The method based on distance [①Borden's measurement; ② cervical curvature index (CCI); ③ vertebral body cardiogram (CCL) measurement method] and Angle [①C1-C7 Cobb Angle measurement method; ②C2-C7Cobb Angle measurement; ③Harrison's measurement (CSA)]. A total of 6 measurement methods were used to measure the cervical curvature of children and adolescents, and the measurement results were statistically analyzed. Results Borden's method and CCL method showed there were statistical differences between 13-15 year old group and the first four groups (P<0.05). C1-C7 Cobb Angle measurement showed that there were statistical differences between the 16-18 year old group and the first five groups (P<0.05). Harrison's method and CCL method showed that there were statistical differences between the five groups aged 4-18 years and the group aged 1-3 years (P<0.05). There was no statistical difference between the genders. The correlation coefficient of Angle-based curvature measurement method was poor, but there were significant differences among all indexes (P<0.05). Conclusions There are many measurement methods for cervical curvature, and each index has its own advantages. Different clinical measurement methods can be adopted according to the research object and content, so as to provide theoretical and technical support for the early diagnosis, prevention and treatment of cervical curvature in children and adolescents.

Key words: Cervical spine curvature; , , Children; , , Teenagers; , , CT; , , Cobb Angle; , , Borden method

中图分类号:

R323.1

李琨, 张博然, 张宇, 韩可铭, 冯杰, 吴思瑶, 苏欣, 苏娜, 王超群, 张少杰, 李志军, 王星. 儿童及青少年颈椎生理弯曲相关指标测量及临床意义[J]. 中国临床解剖学杂志, 2023, 41(6): 675-679.

Li Kun#, Zhang Boran#, Zhang Yu, Han Keming, Feng Jie, Wu Siyao, Su Xin, Su Na, Wang Chaoqun, Zhang Shaojie, Li Zhijun, Wang Xing . Measurement and clinical significance of cervical spine physiological curvature in children and adolescents[J]. Chinese Journal of Clinical Anatomy, 2023, 41(6): 675-679.

参考文献 20

[1]	张明才, 牛阿凤, 石印玉, 等. 上海市青少年颈椎亚健康状况调查及影响因素分析[J]. 上海中医药杂志, 2014, 48(3): 7-9. CNKI: SUN:SHZZ.0.2014-03-004.
[2]	刘湘, 龙耀武, 王锋, 等. 颈椎病严重程度与颈椎曲度相关性的影像学研究[J]. 临床放射学杂志, 2018, 37(6): 1021-1024. CNKI: SUN:LCFS.0.2018-06-035.
[3]	Vialle R, Levassor N, Rillardon L, et al. Radiographic analysis of thesagittal alignment and balance of the spine in asymptomatic subjects[J]. J Bone Joint Surg Am, 2005, 87(2): 260-267. DOI: 10.2106/JBJS.D.02043.
[4]	Iyer S, Nemani VM, Nguyen J, et al. Impact of cervical sagittal alignment parameters on neck disability[J]. Spine (Phila Pa1976), 2016, 41(5): 371-377. DOI: 10.1097/brs.0000000000001221.
[5]	Harrison DE, Harrison DD, Troyanovich SJ, et al. A normal spinal position: its time to accept the evidence[J]. J Manipulative Physiol Ther, 2000, 23(9): 623-644. DOI: 10.1067/mmt.2000.110941.
[6]	Miyazaki M, Hymanson HJ, Morishita Y, et al. Kinematic analysis of the relationship between sagittal alignment and disc degeneration in the cervical spine[J]. Spine (Phila Pa 1976), 2008, 33(23): E870-E876. DOI: 10.1097/BRS.0b013e3181839733.
[7]	方文, 石志才, 贾连顺. 颈椎病患者颈椎曲度的X线测量[J]. 颈腰痛杂志, 1999, 20(2): 83-86. DOI: 10.3969/j.issn.1005-7234.1999.02.003.
[8]	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. DOI: 10.3969/j.issn.1005-7234.1999.02.003.
[9]	周永富, 王志宏, 杜婷, 等. 颈椎曲度与颈痛相关性的临床研究[J]. 颈腰痛杂志, 2015, 36(5): 406-409. DOI: 10.3969/j.issn.1005-7234.2015.00.000.
[10]	吴涛, 刘军, 王刚. X射线、CT、MRI评估C_7椎体显示不清颈椎退变性疾病C_(2-7)Cobb角的可靠性[J]. 中国组织工程研究, 2018, 22(31): 4993-4997. DOI: 10.3969/j.issn.2095-4344.0334.
[11]	Jun HS, Chang IB, Song JH, et al. Is it possible to evaluate the parameters of cervical sagittal alignment on cervical computed tomographic scans[J]. Spine (Phila Pa 1976), 2014, 39(10): E630-E636. DOI: 10.1097/BRS.0000000000000281.
[12]	李军朋, 李义凯, 王志宏. 四种颈椎曲度测量方法的可靠性研究[J]. 颈腰痛杂志, 2002, 23(4): 278-280. DOI: 10.3969/j.issn.1005-7234. 2002.04.004.
[13]	Takeshita K, Murakami M, Kobayashi A, et al. Relationship between cervical curvature index (Ishihara) and cervical spine angle (C2-7)[J]. J Orthop Sci, 2001, 6(3): 223-226. DOI: 10.1007/s007760100038.
[14]	Ohara A, Miyamoto K, Naganawa T, et al. Reliabilities of and correlations among five standard methods of assessing the sagittal alignment of the cervical spine[J]. Spine, 2006, 31(22): 2585-2591. DOI: 10.1097/01.brs.0000240656.79060.18.
[15]	刘静. 单纯颈椎生理曲度异常是颈椎病的早期x线表现[J]. 中国医药导报, 2007, 4(9):109-110. DOI: 10.3969/j.issn.1673-7210. 2007. 09. 090.
[16]	Harrison DE, Harrison DD, Cailliet R, et al. Cobb method or Harrison posterior tangent method: which to choose for lateral cervical radiographic analysis[J]. Spine, 2000, 25(16): 2072-2078. DOI: 10.1097/00007632-200008150-00011.
[17]	Nguyen NLM, Baluch DA, Patel AA. Cervical sagittal balance: a review[J]. Contemporary Spine Surgery, 2014, 15(1): 1-7.
[18]	张明才, 石印玉, 王翔, 等. 颈椎生理曲度异常对颈椎病发病作用的病例对照研究[J]. 中国骨伤, 2010, 23(10): 746-749. DOI: 10.3969/j.issn.1003-0034.2010.10.008.
[19]	何剑波, 苏国义, 林定坤. 未成年人颈痛与颈椎曲度相关性的回顾分析[J]. 中华中医药杂志, 2017, 32(8): 3812-3815. CNKI: SUN:BXYY.0.2017-08-131.
[20]	Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain[J]. Eur Spine J, 2007, 16(5): 669-678. DOI: 10.1007/s00586-006-0254-1.

儿童及青少年颈椎生理弯曲相关指标测量及临床意义

Measurement and clinical significance of cervical spine physiological curvature in children and adolescents

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