Alizada Mirwais, Li Rong Rui, Hayatullah Gati
Department of Orthopedics-II, First Affiliated Hospital, Jiamusi University, Jiamusi 188 xuefu road, 154000, Jiamusi, Heilongjiang, China.
Orthopade. 2018 Dec;47(12):977-985. doi: 10.1007/s00132-018-3635-3.
Cervical spondylosis is one of the most common causes of cervical instability. Various methods are used for measuring cervical instability on X‑ray films. The purpose of this study was to assess the application of the radiographic index method to analyze the radiographic features of cervical spondylosis instability.
Digitized dynamic radiographs of 121 subjects with cervical spondylosis were retrospectively retrieved. The cervical spondylosis patients were divided into two groups according to the symptoms: patients with positive neurological deficits with and without neck symptoms (group I, n = 62) and patients with neck symptoms only (group II, n = 59). A total of 62 healthy subjects were assigned to the control group (group III). The radiographic indices of cervical curvature, the full flexion to full extension ranges of motion (ROM) and horizontal displacement of the three groups were analyzed and compared with each other.
On flexion-extension views there were significant differences (p = 0.00000 [significance of cervical lordosis on flexion view between the three groups], p = 0.00271 [significant difference of cervical lordosis between the three groups on extension view]) between the three groups concerning the cervical lordosis: group I had the least cervical curvature, followed by group II and group III. The full flexion to full extension ranges of motion for group I was significantly decreased (p = 0.0039) when compared with group II and group III. The horizontal displacement at each segmental level (except C2/C3) was significantly higher in group I than that of the other two groups.
With the application of the radiographic index method, cervical spine lordosis, the full flexion to full extension ROM, horizontal displacement, and cervical instability can be accurately illustrated. Cervical spondylosis is an age-related, wear and tear change of the spine that occurs over time. The index of the horizontal displacement ≥0.3 is suggestive of cervical instability.
颈椎病是颈椎不稳最常见的病因之一。X线片上有多种测量颈椎不稳的方法。本研究的目的是评估影像学指数法在分析颈椎病不稳影像学特征中的应用。
回顾性收集121例颈椎病患者的数字化动态X线片。根据症状将颈椎病患者分为两组：有神经功能缺损阳性且有或无颈部症状的患者（I组，n = 62）和仅有颈部症状的患者（II组，n = 59）。共62例健康受试者被纳入对照组（III组）。分析并比较三组的颈椎曲度影像学指数、全屈至全伸活动范围（ROM）和水平位移。
在屈伸位片上，三组在颈椎前凸方面存在显著差异（p = 0.00000[三组之间屈曲位颈椎前凸的显著性]，p = 0.00271[三组之间伸展位颈椎前凸的显著差异]）：I组颈椎曲度最小，其次是II组和III组。与II组和III组相比，I组的全屈至全伸活动范围显著减小（p = 0.0039）。I组在每个节段水平（C2/C3除外）的水平位移明显高于其他两组。
应用影像学指数法可准确显示颈椎前凸、全屈至全伸ROM、水平位移及颈椎不稳情况。颈椎病是一种随时间发生的与年龄相关的脊柱磨损性改变。水平位移指数≥0.3提示颈椎不稳。
