Liao Li-Qing, Li Yi-Kai, Yuan Feng, Qi Ji
School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China.
School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China.
J Manipulative Physiol Ther. 2019 Jan;42(1):82-88. doi: 10.1016/j.jmpt.2018.05.002.
The purpose of this study was to evaluate the osseous variation of the axis spinous process as it may relate to palpation by clinicians.
Morphologies of the bifid spinous process in the intact dry axis of 121 Chinese adult were investigated and classified. The angular deflection of the spinous processes, the bifid spinous processes (the bifid portions of the spinous processes), and the length of the bifid spinous processes were observed and measured.
The bifid spinous process morphologies were classified into 4 types: inverted-V shape (n = 49), inverted-U shape (n = 50), M shape (n = 18), and nonbifid spinous processes (n = 4). The direction of the spinous processes and bifid spinous processes were consistent because they depended on each other's direction of deviation. When the correlation between angular deflection of spinous processes and bifid spinous processes was analyzed, the right deviations of spinous process specimens (29 cases) showed that angular deflections of spinous processes were equal to bifid spinous processes and there was no statistically significant difference seen between them (t = 0.286, P > .05), whereas in the left deviations of spinous process specimens (49 cases), the angular deflection of spinous processes were not equal in length, but bigger than the bifid spinous processes, which was statistically significant (t = -3.079, P = .003 < .05).
The anatomical structure of the spinous processes and the bifid spinous processes vary from one another, but they exhibit some regularity. In clinical spinal manipulation practice, the anatomical characteristic of the axis should be taken into account during cervical static palpation, diagnostic imaging, and treatment.
本研究旨在评估枢椎棘突的骨质变异情况，因为其可能与临床医生的触诊有关。
对121例中国成年完整干燥枢椎的双叉棘突形态进行了研究和分类。观察并测量了棘突的角偏斜、双叉棘突（棘突的双叉部分）以及双叉棘突的长度。
双叉棘突形态分为4种类型：倒V形（n = 49）、倒U形（n = 50）、M形（n = 18）和非双叉棘突（n = 4）。棘突和双叉棘突的方向是一致的，因为它们相互依赖彼此的偏斜方向。分析棘突角偏斜与双叉棘突之间的相关性时，棘突标本向右偏斜（29例）显示，棘突的角偏斜与双叉棘突相等，两者之间无统计学显著差异（t = 0.286，P > 0.05）；而在棘突标本向左偏斜（49例）中，棘突的角偏斜长度不等，但大于双叉棘突，具有统计学显著性（t = -3.079，P = 0.003 < 0.05）。
棘突和双叉棘突的解剖结构各不相同，但呈现出一定规律性。在临床脊柱手法操作实践中，颈椎静态触诊、诊断性影像学检查及治疗过程中应考虑枢椎的解剖特征。
