Kitagawa Tomoaki, Fujiwara Atsushi, Kobayashi Naoki, Saiki Kazuhiko, Tamai Kazuya, Saotome Koichi
Department of Orthopedics, Dokkyo University School of Medicine, Shimotsuga, Japan.
Spine (Phila Pa 1976). 2004 Dec 15;29(24):2821-5. doi: 10.1097/01.brs.0000147741.11273.1c.
Dimensional measurement of cervical neural foramen at various positions, using reformatted computed tomography.
To examine the morphologic changes in the neural foramen during flexion and extension of the cervical spine in vivo.
Previous cadaveric studies have shown the effect of cervical spinal motion on dimensions of the neural foramen. However, little information is available about dynamic morphologic changes in the cervical neural foramen in vivo.
Cervical CT images of seven healthy volunteers were taken at the neutral position, maximum extension, and maximum flexion, and were reconstructed in the oblique plane perpendicular to the long axis of each neural foramen from the C3-C4 to C6-C7 level. Measured parameters included foraminal height, width, cross-sectional area, and segmental sagittal rotation at each spinal level. Differences in neural foraminal dimensions among these positions were analyzed. Correlations of segmental sagittal rotation with differences in dimensions between flexion and extension were analyzed.
Flexion significantly increased the foraminal height (by 1.0 mm; 11%), foraminal width (by 1.0 mm; 16%), and foraminal area (by 12 mm2; 28%) (P < 0.01). Extension significantly decreased the foraminal height (by 0.9 mm; 10%), foraminal width (by 1.4 mm; 22%), and foraminal area (by 8.0 mm2; 17%) (P < 0.01). Segmental sagittal rotation significantly positively correlated with % change in foraminal height (r = 0.434, P < 0.01) and area (r = 0.504, P < 0.01).
The present results are consistent with those of previous in vitro studies and may explain the clinical observation that cervical extension aggravates symptoms in patients with cervical radiculopathy and that flexion often relieves them.
使用重组计算机断层扫描对颈椎神经孔在不同位置进行尺寸测量。
研究活体颈椎屈伸过程中神经孔的形态学变化。
以往的尸体研究已显示颈椎运动对神经孔尺寸的影响。然而，关于活体颈椎神经孔动态形态学变化的信息却很少。
对7名健康志愿者在中立位、最大伸展位和最大屈曲位进行颈椎CT扫描，并从C3 - C4至C6 - C7水平在垂直于每个神经孔长轴的斜平面上进行重建。测量参数包括每个脊柱节段的神经孔高度、宽度、横截面积和节段矢状面旋转度。分析这些位置之间神经孔尺寸的差异。分析节段矢状面旋转度与屈伸之间尺寸差异的相关性。
屈曲显著增加神经孔高度（增加1.0毫米；11%）、神经孔宽度（增加1.0毫米；16%）和神经孔面积（增加12平方毫米；28%）（P < 0.01）。伸展显著降低神经孔高度（降低0.9毫米；10%）、神经孔宽度（降低1.4毫米；22%）和神经孔面积（降低8.0平方毫米；17%）（P < 0.01）。节段矢状面旋转度与神经孔高度的变化百分比（r = 0.434，P < 0.01）和面积的变化百分比（r = 0.504，P < 0.01）显著正相关。
目前的结果与以往的体外研究结果一致，可能解释了临床观察到的颈椎伸展加重神经根型颈椎病患者症状而屈曲常可缓解症状的现象。
