Mekata Kojiro, Takigawa Tomoyuki, Matsubayashi Jun, Hasegawa Yasuhiro, Ito Yasuo
Department of Rehabilitation, Kobe Red Cross Hospital, 1-3-1 Wakinohamakaigandori, Chuo-ku, Kobe City, Hyogo, 651-0073, Japan.
Eur Spine J. 2013 Nov;22(11):2558-63. doi: 10.1007/s00586-013-2975-2. Epub 2013 Aug 31.
There have been several studies regarding the relationship between deglutition and the cervical spine; however, the movement of the cervical spine during deglutition has not been specifically studied. The purpose of the present study was to clarify how the cervical spine moves during normal deglutition.
We conducted videofluorography in 39 healthy individuals (23 men; 16 women; mean age, 34.3 years) with no evidence of cervical spine disease and analyzed images of the oral and pharyngeal phases of swallowing using an image analysis technique. Analyzed sections included the occiput (C0) and the first to seventh cervical vertebrae (C1-C7). The degrees of change in angle and position were quantified in the oral and pharyngeal phases.
In the pharyngeal phase, C1, C2, and C3 were flexed (the angle change in C2 was the most significant with a mean flexion angle of 1.42°), while C5 and C6 were extended (the angle change in C5 was the most significant with a mean extension angle of 0.74°) in reference to the oral phase. Angle changes in C0, C4, and C7 were not statistically significant. C3, C4, C5, and C6 moved posteriorly (the movement in C4 was the most significant, mean = 1.04 mm). C1, C2, and C3 moved superiorly (the movement in C2 was the largest, mean = 0.55 mm), and C5 and C6 moved inferiorly. Movements in C0 and C7 were not statistically significant.
These findings suggest that the cervical spine moves to reduce physiological lordosis during deglutition.
已有多项关于吞咽与颈椎关系的研究；然而，吞咽过程中颈椎的运动尚未得到专门研究。本研究的目的是阐明正常吞咽过程中颈椎是如何运动的。
我们对39名无颈椎疾病证据的健康个体（23名男性；16名女性；平均年龄34.3岁）进行了视频荧光吞咽造影，并使用图像分析技术分析吞咽口腔期和咽期的图像。分析的节段包括枕骨（C0）和第一至第七颈椎（C1 - C7）。在口腔期和咽期对角度和位置的变化程度进行量化。
在咽期，相对于口腔期，C1、C2和C3屈曲（C2的角度变化最显著，平均屈曲角度为1.42°），而C5和C6伸展（C5的角度变化最显著，平均伸展角度为0.74°）。C0、C4和C7的角度变化无统计学意义。C3、C4、C5和C6向后移动（C4的移动最显著，平均值 = 1.04 mm）。C1、C2和C3向上移动（C2的移动最大，平均值 = 0.55 mm），C5和C6向下移动。C0和C7的移动无统计学意义。
这些发现表明，吞咽过程中颈椎运动会减少生理性前凸。
