Gao Kun, Zhang Jiliang, Lai Jinquan, Liu Weidong, Lyu Hanqing, Wu Yihong, Lin Zhanpeng, Cao Yafei
Shenzhen Traditional Chinese Medicine Hospital.
The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China.
Medicine (Baltimore). 2019 Aug;98(31):e16545. doi: 10.1097/MD.0000000000016545.
Abnormal cervical curvature and cervical disc herniation are closely related to neck pain and should be taken into account before any treatment. However, studies have rarely reported on the correlation between cervical lordosis and cervical disc herniation in patients with neck pain. Therefore, in this study, we collect young neck pain patients with abnormal cervical curvature to evaluate the relationship between cervical lordosis and cervical disc herniation.Three hundred patients below 40 years old with neck pain were enrolled. Patient sex, age, apical vertebra, segment of intervertebral disc protrusionl, sagittal diameter of spinal duramater, saggital diameter of spinal canal, height of disc space were recorded, and the cervical curvature, and degree of cervical spinal cord compression (G/F ratio) were calculated. The change of degree of disc herniation and degree of cervical spinal cord compression were analyzed in different cervical curvature groups. Further more, collected these patients who had improved cervical curvature over a period of time, to compare the changes of degree of disc herniation, G/F ratio, and height of disc space.The median age of patients with kyphosis was lower than those with lordosis and straight cervical spine. The degree of disc herniation was higher in the straight and kyphosis groups compared to the lordosis group. Cervical lordosis was inversely correlated with the degree of disc herniation and positively with G/F ratio. Cervical curvature was significantly affected by sex, age, and the degree of disc herniation. With the improvement of cervical lordotic curvature, the degree of disc herniation decreased and height of disc space increased.The degree of disc herniation and cervical spinal cord compression are inversely correlated to cervical lordosis in young neck pain patients, and the degree of disc herniation and height of disc space can recover with the recovery of cervical lordotic curvature. These findings may indicating a link between cervical curvature and degenerative changes which have important clinical implications.
颈椎曲度异常和颈椎间盘突出与颈部疼痛密切相关，在任何治疗之前都应予以考虑。然而，关于颈部疼痛患者颈椎前凸与颈椎间盘突出之间的相关性研究报道很少。因此，在本研究中，我们收集了颈椎曲度异常的年轻颈部疼痛患者，以评估颈椎前凸与颈椎间盘突出之间的关系。
招募了300例40岁以下的颈部疼痛患者。记录患者的性别、年龄、顶椎、椎间盘突出节段、硬脊膜矢状径、椎管矢状径、椎间隙高度，并计算颈椎曲度和颈脊髓压迫程度（G/F比值）。分析不同颈椎曲度组中椎间盘突出程度和颈脊髓压迫程度的变化。此外，收集了在一段时间内颈椎曲度有所改善的这些患者，以比较椎间盘突出程度、G/F比值和椎间隙高度的变化。
后凸患者的中位年龄低于前凸和颈椎直线型患者。与前凸组相比，直线型和后凸组的椎间盘突出程度更高。颈椎前凸与椎间盘突出程度呈负相关，与G/F比值呈正相关。颈椎曲度受性别、年龄和椎间盘突出程度的显著影响。随着颈椎前凸曲度的改善，椎间盘突出程度降低，椎间隙高度增加。
在年轻颈部疼痛患者中，椎间盘突出程度和颈脊髓压迫与颈椎前凸呈负相关，随着颈椎前凸曲度的恢复，椎间盘突出程度和椎间隙高度可以恢复。这些发现可能表明颈椎曲度与退变改变之间存在联系，具有重要的临床意义。
