颈椎骨质增生的退变规律及相关研究
发布时间：2019-04-26 17:25
【摘要】：目的 研究颈椎退行性变的规律以及退行性变与性别、年龄的相关性。 材料与方法 随机选择580例做颈椎CT检查的患者进行回顾性分析和总结，年龄13-70岁，其中男352例、女228例，所有患者均行16层螺旋CT（MSCT）检查，选用B60骨窗扫描条件。0.75mm薄层重建后，在3D三维重建系统中进行标准横轴位、矢状位、冠状位、曲面及VRT重建，然后观察。主要观察内容为：颈椎各椎体、附件骨质增生，韧带钙化骨化及生理曲度改变，并记录各种征象的年龄、性别。用SPSS17.0软件进行统计学相关性分析。 结果 1．颈椎椎体骨质增生：（1）颈椎骨质增生最早发生于颈1、2，平均年龄44-47岁，男性最早发生的年龄43.54±20.535岁，女性最早发生年龄46.00±20.535岁， P0.05，有性别差异；颈7椎体出现的最晚，平均年龄56.76±15.823岁。（2）按照颈椎骨质增生发生的早晚依次为颈1、颈2椎体、颈5、6、颈4、7。颈3椎体骨质增生最少见。 2．颈椎附件骨质增生最早见于颈4-7，平均年龄为56-57岁左右，颈1-6椎体附件骨质增生男性出现的年龄较女性稍大(P0.05)。 3．韧带钙化情况：（1）寰枢椎韧带及前纵韧带：寰枢椎韧带及颈4-7前纵韧带骨化、钙化年龄最早，约51-52岁；颈2前纵韧带出现的年龄最晚，平均年龄67.00±2.828岁。有男女差别(P0.05)，，女性较男性稍早出现韧带钙化骨化。（2）后纵韧带：颈3后纵韧带出现的年龄最早，平均年龄47.22±13.000岁，女性出现早，平均年龄45.00±12.780岁，男性出现的平均年龄为47.86±13.467岁。颈2水平后纵韧带出现的年龄最晚，平均年龄55.33±13.125岁。大部分女性均较男性早出现后纵韧带的钙化骨化。（3）项韧带：颈4-7水平项韧带最早出现钙化，平均年龄约50-53岁，颈2水平项韧带出现钙化的年龄最晚，平均年龄约59岁左右。男女无明显差异(P0.05)。 4.颈椎曲度：颈椎曲度Y 直平均年龄45.04±15.190岁，反曲出现平均年龄为48.30±15.696岁，男女有差别(P0.05)，男性出现弧度变化的平均年龄较早，男性曲度Y 直的平均年龄为41.02±15.813岁，反曲的平均年龄为44.64±15.992岁，女性颈椎曲度Y 直的平均年龄为49.72±13.115岁，反曲的平均年龄为52.60±14.255岁。 结论 1.颈椎最早出现退行性改变的CT影像征象中：颈椎椎体骨质增生最早出现的时间基本同颈椎生理曲度改变最早出现的时间，其中颈椎最早出现骨质增生的椎体为颈1、2；韧带钙化骨化与椎体附件骨质增生相比，其后纵韧带钙化年龄最早，韧带钙化骨化早于椎体附件（颈4-7）出现骨质增生。 2.部分附件骨质增生、寰枢椎韧带、前纵及部分后纵韧带钙化骨化的出现女性早于男性。 3.MSCT由于其可多角度显示图像及分辨率高，有利于发现颈椎细微结构的骨质增生的改变，对于颈椎早期和轻度的骨质增生的发现有较高价值。
[Abstract]:Objective to study the regularity of cervical degenerative change and its correlation with sex and age. Materials and methods A total of 580 patients with cervical CT were retrospectively analyzed and summarized. The age was 13 ~ 70 years old, including 352 males and 228 females. All patients underwent 16-slice spiral CT (MSCT), and all the patients were examined with 16-slice spiral CT (MSCT), and all the patients were examined with 16-slice spiral CT (MSCT). B60 bone window scanning condition was used. 0.75 mm thin slice reconstruction was performed in 3D 3D reconstruction system, including standard transverse, sagittal, coronal, curved and VRT reconstruction, and then observed. The main observations were as follows: cervical vertebrae, hyperosteogeny of appendages, calcification of ligaments and changes of physiological curvature, and the age and sex of all signs were recorded. Statistical correlation analysis was performed with SPSS17.0 software. Results 1. Cervical vertebra hyperosteogeny: (1) Cervical hyperosteogeny first occurred in C1, 2, with an average age of 44 to 47 years. The earliest occurrence of cervical hyperosteogeny was 43.54 卤20.535 years in males and 46.00 卤20.535 years in females, P0.05, There are gender differences; The mean age of C7 was 56.76 卤15.823 years old. (2) according to the occurrence of cervical hyperosteogeny, the order of occurrence of cervical osteogeny was C1, C2, 5, 6, 4, 7, respectively. Cervical 3 vertebrae osteogeny hyperplasia is the most rare. 2. Cervical adnexal osteogeny hyperplasia was first seen at C4-7, with an average age of 56-57 years. The age of cervical adnexal hyperosteogeny was slightly older in males than in females (P0.05). 3. Calcification of ligament: (1) atlantoaxial ligament and anterior longitudinal ligament: atlantoaxial ligament and cervical 4 / 7 anterior longitudinal ligament ossification, the age of calcification was the earliest, about 51 ~ 52 years old; The mean age of the anterior longitudinal ligament was 67.00 卤2.828 years old. (2) the posterior longitudinal ligament: the age of the posterior longitudinal ligament was the earliest, the average age was 47.22 卤13.000 years, the female appeared earlier, the average age was 45.00 卤12.780 years, the average age of the posterior longitudinal ligament was 47.22 卤13.000 years, the average age of the posterior longitudinal ligament was 45.00 卤12.780 years, and the average age of the posterior longitudinal ligament was 45.00 卤12.780 years. The average age of males was 47.86 卤13.467 years old. The age of posterior longitudinal ligament at neck 2 level was the last, with an average age of 55.33 卤13.125 years. The calcification of the posterior longitudinal ligament occurred earlier in most women than in men. (3) ligaments: the first calcification occurred in the cervical 4-7 level ligaments, with an average age of about 50-53 years, and the age of calcification of the cervical-2-level ligaments was the latest. The average age is about 59. There was no significant difference between men and women (P0.05). 4. Cervical curvature: the average age of Y-straight cervical curvature was 45.04 卤15.190 years, and the mean age of reflexion was 48.30 卤15.696 years old. There was significant difference between men and women (P0.05). The mean age of Y-straight was 41.02 卤15.813 years for male, 44.64 卤15.992 years for reverse curvature, 49.72 卤13.115 years for female cervical curvature, 52.60 卤14.255 years for female cervical curvature, and 41.02 卤15.813 years for male, 44.64 卤15.992 years for reverse curvature, 49.72 卤13.115 years for female cervical curvature and 52.60 卤14.255 years for female cervical curvature. Conclusion 1. Among the CT imaging signs of the earliest degenerative changes of cervical vertebrae: the earliest appearance time of cervical vertebra osteogeny hyperplasia was the same as the earliest appearance of cervical physiological curvature change, in which the first cervical vertebra appeared hyperosteogeny was C1, 2, and that of cervical vertebra hyperosteogeny was the same as that of cervical vertebra physiological curvature change. Compared with the hyperosteogeny of the vertebral appendage, the calcification of the ligaments was the earliest, and the calcification of the ligaments was earlier than that of the appendages of the vertebrae (C4 / 7). 2. The ossification of accessory osteogeny, atlantoaxial ligament, anterior longitudinal ligament and posterior longitudinal ligament was earlier in female than in male. Because of its multi-angle image and high resolution, 3.MSCT is helpful to find the change of bone hyperplasia in the fine structure of cervical vertebra. It is of high value for early and mild cervical bone hyperplasia.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R681.5;R816.8
本文编号：2466246
[Abstract]:Objective to study the regularity of cervical degenerative change and its correlation with sex and age. Materials and methods A total of 580 patients with cervical CT were retrospectively analyzed and summarized. The age was 13 ~ 70 years old, including 352 males and 228 females. All patients underwent 16-slice spiral CT (MSCT), and all the patients were examined with 16-slice spiral CT (MSCT), and all the patients were examined with 16-slice spiral CT (MSCT). B60 bone window scanning condition was used. 0.75 mm thin slice reconstruction was performed in 3D 3D reconstruction system, including standard transverse, sagittal, coronal, curved and VRT reconstruction, and then observed. The main observations were as follows: cervical vertebrae, hyperosteogeny of appendages, calcification of ligaments and changes of physiological curvature, and the age and sex of all signs were recorded. Statistical correlation analysis was performed with SPSS17.0 software. Results 1. Cervical vertebra hyperosteogeny: (1) Cervical hyperosteogeny first occurred in C1, 2, with an average age of 44 to 47 years. The earliest occurrence of cervical hyperosteogeny was 43.54 卤20.535 years in males and 46.00 卤20.535 years in females, P0.05, There are gender differences; The mean age of C7 was 56.76 卤15.823 years old. (2) according to the occurrence of cervical hyperosteogeny, the order of occurrence of cervical osteogeny was C1, C2, 5, 6, 4, 7, respectively. Cervical 3 vertebrae osteogeny hyperplasia is the most rare. 2. Cervical adnexal osteogeny hyperplasia was first seen at C4-7, with an average age of 56-57 years. The age of cervical adnexal hyperosteogeny was slightly older in males than in females (P0.05). 3. Calcification of ligament: (1) atlantoaxial ligament and anterior longitudinal ligament: atlantoaxial ligament and cervical 4 / 7 anterior longitudinal ligament ossification, the age of calcification was the earliest, about 51 ~ 52 years old; The mean age of the anterior longitudinal ligament was 67.00 卤2.828 years old. (2) the posterior longitudinal ligament: the age of the posterior longitudinal ligament was the earliest, the average age was 47.22 卤13.000 years, the female appeared earlier, the average age was 45.00 卤12.780 years, the average age of the posterior longitudinal ligament was 47.22 卤13.000 years, the average age of the posterior longitudinal ligament was 45.00 卤12.780 years, and the average age of the posterior longitudinal ligament was 45.00 卤12.780 years. The average age of males was 47.86 卤13.467 years old. The age of posterior longitudinal ligament at neck 2 level was the last, with an average age of 55.33 卤13.125 years. The calcification of the posterior longitudinal ligament occurred earlier in most women than in men. (3) ligaments: the first calcification occurred in the cervical 4-7 level ligaments, with an average age of about 50-53 years, and the age of calcification of the cervical-2-level ligaments was the latest. The average age is about 59. There was no significant difference between men and women (P0.05). 4. Cervical curvature: the average age of Y-straight cervical curvature was 45.04 卤15.190 years, and the mean age of reflexion was 48.30 卤15.696 years old. There was significant difference between men and women (P0.05). The mean age of Y-straight was 41.02 卤15.813 years for male, 44.64 卤15.992 years for reverse curvature, 49.72 卤13.115 years for female cervical curvature, 52.60 卤14.255 years for female cervical curvature, and 41.02 卤15.813 years for male, 44.64 卤15.992 years for reverse curvature, 49.72 卤13.115 years for female cervical curvature and 52.60 卤14.255 years for female cervical curvature. Conclusion 1. Among the CT imaging signs of the earliest degenerative changes of cervical vertebrae: the earliest appearance time of cervical vertebra osteogeny hyperplasia was the same as the earliest appearance of cervical physiological curvature change, in which the first cervical vertebra appeared hyperosteogeny was C1, 2, and that of cervical vertebra hyperosteogeny was the same as that of cervical vertebra physiological curvature change. Compared with the hyperosteogeny of the vertebral appendage, the calcification of the ligaments was the earliest, and the calcification of the ligaments was earlier than that of the appendages of the vertebrae (C4 / 7). 2. The ossification of accessory osteogeny, atlantoaxial ligament, anterior longitudinal ligament and posterior longitudinal ligament was earlier in female than in male. Because of its multi-angle image and high resolution, 3.MSCT is helpful to find the change of bone hyperplasia in the fine structure of cervical vertebra. It is of high value for early and mild cervical bone hyperplasia.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R681.5;R816.8
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