Xu Jin-Hai, Mo Wen, Ye Jie, Ma Jun-Ming, Wan Hong-Bo, Tong Zheng-Yi, Ma Jun-ming
Department of Orthopaedics and Traumatology, the Affiliated Longhua Hospital of Shanghai, University of Traditional Chinese Medicine, Shanghai, China.
Zhongguo Gu Shang. 2012 Sep;25(9):715-20.
To discuss the correlation between the degree of cervical spinal cord compression and gender, age, height of intervertebral space and the abnormality curvature of cervical vertebrae. The multivariable linear regression was used to build the prediction model of cervical spinal cord compression.
One hundred and twenty patients with cervical spondylosis were divided into 4 groups according to the degree of spinal cord compression. To measure the sagittal diameter of spinal cord (a) and medulla-pons junction (M) in MRI individually, and then calculate the ratio of a/M; according to the ratio to evaluate the degree of cervical spinal cord compression. In X-ray films to measure the height and angle of intervertebral space, curvature of cervical vertebrae (according to Borden's method and double line method of C2-7 Cobb angle to abtain data of curvature of cervical vertebrae). To performe linear regression and multiple linear regression to analyze the correlation above the data and build the prediction model of cervical spinal cord compression.
(1) With the exacerbation of cervical spinal cord compression, all measured data gradually decreased; there was significant difference in the anterior height and angle of intervertebral space, the ratio of a/M between any two groups (P < 0.05). (2) The ratio of a/M showed positive corrrelation with the anterior height of intervertebral space (R = 0.296, P < 0.001) and the curvature of cervical vertebrae (are to chord distance, R = 0.241, P < 0.001), but showed negative corrrelation with the proportion of cervical spinal cord compression (R = -0.821, P < 0.001); Borden's method are to chord distance) showed positive correlation with the double line method of C2-7 Cobb angle (R = 0.840, P < 0.001). The predictive equation of the ratio of a/M by multiple linear regression was obtained, and the F = 8.959, R = 0.434, P < 0.001, in which the age, the anterior height of intervertebral space and the curvature of cervical vertebrae were risk factors of cervical spinal cord compression.
The ratio of a/M can be a standard to evaluate degree of cervical spinal cord compression; the changes of the height of intervertebral disc, curvature of cervical vertebrae in X-ray films maybe have values to predict the degree of cervical spinal cord compression.
探讨颈脊髓受压程度与性别、年龄、椎间隙高度及颈椎异常曲度之间的相关性。采用多变量线性回归建立颈脊髓受压的预测模型。
将120例颈椎病患者根据脊髓受压程度分为4组。分别在MRI上测量脊髓矢状径（a）和延髓脑桥交界处（M），然后计算a/M比值；根据该比值评估颈脊髓受压程度。在X线片上测量椎间隙高度和角度、颈椎曲度（根据Borden法和C2-7 Cobb角双线法获取颈椎曲度数据）。进行线性回归和多重线性回归分析上述数据间的相关性并建立颈脊髓受压的预测模型。
（1）随着颈脊髓受压程度加重，所有测量数据逐渐降低；任意两组之间椎间隙前缘高度和角度、a/M比值差异均有统计学意义（P < 0.05）。（2）a/M比值与椎间隙前缘高度（R = 0.296，P < 0.001）和颈椎曲度（矢状径与弦距，R = 0.241，P < 0.001）呈正相关，但与颈脊髓受压比例呈负相关（R = -0.821，P < 0.001）；Borden法矢状径与弦距）与C2-7 Cobb角双线法呈正相关（R = 0.840，P < 0.001）。通过多重线性回归得到a/M比值的预测方程，F = 8.959，R = 0.434，P < 0.001，其中年龄、椎间隙前缘高度和颈椎曲度是颈脊髓受压的危险因素。
a/M比值可作为评估颈脊髓受压程度的标准；X线片上椎间盘高度、颈椎曲度的变化可能对预测颈脊髓受压程度有价值。
