Wang Hongli, Sun Chi, Yang Shuo, Jiang Jianyuan, Lu Feizhou, Ma Xiaosheng, Xia Xinlei
Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
World Neurosurg. 2018 Jun;114:e433-e440. doi: 10.1016/j.wneu.2018.03.004. Epub 2018 Mar 10.
To evaluate the cervical spine alignment and range of motion (ROM) of neck flexion in patients with Hirayama disease.
Fifty male patients were included, with dynamic radiographs and magnetic resonance imaging (MRI) analyzed retrospectively. The Cobb angles for the entire cervical spine (C2-C7) and each level (C2/3-C6/7) were measured, and the neck flexion ROM was defined as the neutral Cobb angle minus the flexion Cobb angle. Paired t tests and Wilcoxon signed-rank tests were used to compare the Cobb angles and ROM between radiographs and MRI.
The neutral and flexion Cobb angles decreased from C2/3 to C5/6 but increased at C6/7 on radiographs and MRI. The neutral Cobb angle of C2-C7 from radiographs was significantly larger than that seen on MRI (5.27° vs. -3.26°; P < 0.0001). Neck flexion ROM seen with MRI tended to be lower than those of corresponding levels on radiographs. The ROM of C2-C7, C3/4, and C6/7 on radiographs was significantly larger than that seen with MRI (37.86° vs. 26.59°, P < 0.0001; 7.46° vs. 5.10°, P = 0.0071; and 10.45° vs. 7.03°, P = 0.0023, respectively). For the lower cervical levels, the largest and second largest ROM were seen in C5/6 and C6/7 on the radiographs but C5/6 and C4/5 on MRI.
The cervical spine alignment and neck flexion ROM in Hirayama disease differed between radiographs and MRI. Both imaging techniques should be examined comprehensively when planning an operation.
评估平山病患者的颈椎排列及颈部前屈活动度（ROM）。
纳入50例男性患者，对其动态X线片和磁共振成像（MRI）进行回顾性分析。测量整个颈椎（C2-C7）及每个节段（C2/3-C6/7）的Cobb角，颈部前屈ROM定义为中立位Cobb角减去前屈Cobb角。采用配对t检验和Wilcoxon符号秩检验比较X线片和MRI之间的Cobb角及ROM。
X线片和MRI上，中立位和前屈Cobb角从C2/3至C5/6减小，但在C6/7增大。X线片上C2-C7的中立位Cobb角显著大于MRI所见（5.27°对-3.26°；P<0.0001）。MRI显示的颈部前屈ROM往往低于X线片上相应节段的ROM。X线片上C2-C7、C3/4和C6/7的ROM显著大于MRI所见（分别为37.86°对26.59°，P<0.0001；7.46°对5.10°，P=0.0071；10.45°对7.03°，P=0.0023）。对于下颈椎节段，X线片上ROM最大和第二大的节段分别为C5/6和C6/7，而MRI上为C5/6和C4/5。
平山病患者的颈椎排列及颈部前屈ROM在X线片和MRI之间存在差异。在计划手术时，应综合检查这两种成像技术。
