Kumagai Gentaro, Ono Atsushi, Numasawa Takuya, Wada Kanichiro, Inoue Ryo, Iwasaki Hiroki, Iwane Kaori, Matsuzaka Masashi, Takahashi Ippei, Umeda Takashi, Nakaji Shigeyuki, Ishibashi Yasuyuki
Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan,
J Orthop Sci. 2014 May;19(3):390-7. doi: 10.1007/s00776-014-0549-8. Epub 2014 Feb 26.
Radiographic findings may provide clues to the underlying cause of neck symptoms. However, these associations remain controversial. This study investigates the association between roentgenographic findings of the cervical spine and neck symptoms in a Japanese community population.
A total of 762 volunteers participated in this study. Sagittal radiographs of the cervical spine were taken and a questionnaire about the presence of and visual analog scale (VAS) for neck pain or stiff shoulder was completed. The sagittal alignment of the cervical spine (C2-C7) and the degenerative index were measured from lateral aspect radiographs. Three groups based on the sagittal alignment of C2-C7 were defined: straight-spine, lordotic-spine, and kyphotic-spine. The roentgenographic findings were examined in relation to symptoms.
The prevalence rate of stiff shoulder on the day of examination was significantly higher in females than males. Although the VAS for neck pain and stiff shoulder on the examination day and for stiff shoulder in the preceding 12 months were not significantly different between females and males, that for neck pain in the preceding 12 months was significantly higher in females than males. Although there was no association between the sagittal alignment of C2-C7 and neck symptoms in males or females, a significant correlation between the degenerative index and VAS for neck pain on the examination day and in the preceding 12 months was seen in females after adjusting for age. The prevalence of and VAS for neck pain and stiff shoulder were not significantly different among the three C2-C7 sagittal alignment groups.
Although the sagittal alignment of the cervical spine was not associated with neck symptoms, degenerative changes were associated with the severity of neck pain in females.
影像学检查结果可能为颈部症状的潜在病因提供线索。然而,这些关联仍存在争议。本研究调查了日本社区人群中颈椎X线检查结果与颈部症状之间的关联。
共有762名志愿者参与了本研究。拍摄了颈椎矢状位X线片,并完成了一份关于颈部疼痛或肩部僵硬的存在情况及视觉模拟量表(VAS)的问卷。从侧位X线片测量颈椎(C2-C7)的矢状排列和退变指数。根据C2-C7的矢状排列定义了三组:直脊柱组、前凸脊柱组和后凸脊柱组。检查影像学检查结果与症状的关系。
检查当天肩部僵硬的患病率女性显著高于男性。虽然检查当天颈部疼痛和肩部僵硬以及前12个月肩部僵硬的VAS在女性和男性之间无显著差异,但前12个月颈部疼痛的VAS女性显著高于男性。虽然C2-C7的矢状排列与男性或女性的颈部症状之间无关联,但在调整年龄后,女性中退变指数与检查当天及前12个月颈部疼痛的VAS之间存在显著相关性。颈部疼痛和肩部僵硬的患病率及VAS在C2-C7矢状排列的三组之间无显著差异。
虽然颈椎的矢状排列与颈部症状无关,但退变改变与女性颈部疼痛的严重程度有关。