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先天性颈椎融合畸形与相邻尾侧椎间盘有关。

Congenital cervical block vertebrae are associated with caudally adjacent discs.

作者信息

Leivseth Gunnar, Frobin Wolfgang, Brinckmann Paul

机构信息

Faculty of Medicine, Department of Neuromedicine, Norwegian University of Science and Technology, St. Olav University Hospital, P.O. Box 211, Olav Kyrresgt. 16, 7089 Trondheim, Norway.

出版信息

Clin Biomech (Bristol). 2005 Aug;20(7):669-74. doi: 10.1016/j.clinbiomech.2005.04.006.

Abstract

BACKGROUND

Knowledge on the time course of changes in cervical disc height and cervical kinematics at motion segments adjacent to congenital block vertebrae is fragmentary. Compared with this, after surgical fusion of cervical spine segments some find increased degenerative processes in combination with hypermobility or instability while others were unable to confirm these changes. This cross sectional study was undertaken to investigate whether congenital block vertebrae are associated with an increased risk of disc degeneration and hypermobility at adjacent motion segments.

METHODS

In 25 subjects (mean age 40 years) disc height, vertebral height and segmental mobility at motion segments adjacent to a congenital block vertebra were assessed quantitatively by distortion-compensated Roentgen analysis. The findings were compared to a normal database.

FINDINGS

Height of the disc cranially adjacent to the block vertebra did not deviate from the norm while height of the caudally adjacent disc was significantly reduced. The height of the vertebrae adjacent to the block did not deviate from normal. The motion segments formed by the block vertebra and the adjacent discs and vertebrae exhibited no deviation from normal with respect to sagittal plane rotational or translational motion.

INTERPRETATION

Congenital block vertebrae do not result in rotational or translational hyper- or hypomobility at motion segments adjacent to the block. Whether the observed, significant height reduction of the caudally adjacent disc is caused by degeneration following the block formation cannot undoubtedly be concluded as the initial state is not known. Further longitudinal studies are needed to investigate this issue.

摘要

背景

关于先天性融合椎相邻运动节段颈椎间盘高度和颈椎运动学变化的时间进程的知识尚不完整。与此相比,在颈椎节段手术融合后,一些人发现退变过程增加并伴有活动过度或不稳定,而另一些人则无法证实这些变化。本横断面研究旨在调查先天性融合椎是否与相邻运动节段椎间盘退变和活动过度的风险增加相关。

方法

对25名受试者(平均年龄40岁),通过失真补偿X线分析定量评估先天性融合椎相邻运动节段的椎间盘高度、椎体高度和节段活动度。将结果与正常数据库进行比较。

结果

融合椎上方相邻椎间盘的高度与正常无异,而下方相邻椎间盘的高度则显著降低。融合椎相邻椎体的高度与正常无差异。由融合椎以及相邻椎间盘和椎体形成的运动节段在矢状面旋转或平移运动方面与正常无差异。

解读

先天性融合椎不会导致融合椎相邻运动节段出现旋转或平移的活动过度或活动不足。由于初始状态未知,所以无法确定观察到的下方相邻椎间盘高度的显著降低是否由融合形成后的退变所致。需要进一步的纵向研究来调查这个问题。

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