Wang Hongwei, Xu Haocheng, Wang Xianghe, Yang Shuo, Zhang Fan, Lyu Feizhou, Ma Xiaosheng, Jiang Jianyuan, Wang Hongli
Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China; Spine Center Fudan University, Shanghai, China.
Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China; Spine Center Fudan University, Shanghai, China; Department of Orthopedics, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
World Neurosurg. 2025 Mar;195:123605. doi: 10.1016/j.wneu.2024.123605. Epub 2025 Feb 19.
To measure the muscle strength around the cervical spine; clarify the relationships among muscles, cervical sagittal alignment, and cervical spondylotic myelopathy (CSM); and understand the process underlying loss of cervical lordosis.
Sex, age, course of illness, and radiological data were obtained for patients with CSM and a control group of healthy individuals. C2-7 Cobb angles were measured in cervical radiographs, and the vertebral body areas (VBAs) and cross-sectional areas (CSAs) of the deep flexors, superficial flexors, deep extensors, and superficial extensors were measured from the C3/4 to C6/7 intervertebral levels in T2-weighted axial magnetic resonance images. The CSA/VBA ratio was compared among CSM patients with and without degenerative cervical kyphosis (DCK) and control group.
Patients with CSM, especially those with DCK, showed an imbalance of muscles around the cervical spine. The CSA/VBA ratios of superficial flexor/superficial extensor at the C3/4 level (P = 0.036), total flexors/total extensors at the C6/7 level (P = 0.006), total deep muscles/total superficial muscles at the C4/5 level (P = 0.004), and total deep muscles/total superficial muscles at the C6/7 level (P = 0.031) differed significantly among the 3 groups. The CSM with DCK group tended to show larger CSA/VBA ratios of flexors/extensors and superficial muscles/deep muscles.
The greater strength of the flexors relative to the extensors and the superficial muscles compared with the deep muscles plays a role in pathogenesis of CSM with DCK, indicating the importance of neck and shoulder muscle-strengthening exercises in patients showing CSM with DCK.
测量颈椎周围肌肉力量；阐明肌肉、颈椎矢状位排列和脊髓型颈椎病（CSM）之间的关系；并了解颈椎生理前凸丧失的潜在过程。
获取CSM患者和健康个体对照组的性别、年龄、病程及放射学数据。在颈椎X线片上测量C2-7 Cobb角，并在T2加权轴向磁共振图像上从C3/4至C6/7椎间水平测量深层屈肌、浅层屈肌、深层伸肌和浅层伸肌的椎体面积（VBA）和横截面积（CSA）。比较有和没有退变性颈椎后凸（DCK）的CSM患者与对照组之间的CSA/VBA比值。
CSM患者，尤其是患有DCK的患者，表现出颈椎周围肌肉失衡。在C3/4水平，浅层屈肌/浅层伸肌的CSA/VBA比值（P = 0.036）；在C6/7水平，总屈肌/总伸肌的CSA/VBA比值（P = 0.006）；在C4/5水平，深层肌肉总量/浅层肌肉总量的CSA/VBA比值（P = 0.004）；在C6/7水平，深层肌肉总量/浅层肌肉总量的CSA/VBA比值（P = 0.031），三组之间差异有统计学意义。患有DCK的CSM组倾向于表现出屈肌/伸肌和浅层肌肉/深层肌肉更大的CSA/VBA比值。
相对于伸肌和深层肌肉，屈肌和浅层肌肉力量更大在患有DCK的CSM发病机制中起作用，表明颈部和肩部肌肉强化锻炼对表现出患有DCK的CSM患者的重要性。
