Kohno M, Takahashi H, Yagishita A, Tanabe H
Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Japan.
Surg Neurol. 1998 Nov;50(5):421-30. doi: 10.1016/s0090-3019(97)00451-5.
Cervical flexion myelopathy is quite a rare condition affecting mainly adolescent males who present with muscular atrophy of the upper extremities. Its etiology is still unknown, as is the cause of its marked male preponderance. Disproportion of the cervical spine and spinal cord is suspected to be one of the etiological causes, however, this has yet to be confirmed.
We performed a comparative study of the cervical magnetic resonance (MR) images of six male patients with juvenile cervical flexion myelopathy and of 34 young, normal controls.
In normal controls, the cervical spines and spinal cords were significantly straighter in tall than in short males and in females than in males. In these patients, the cervical spine and spinal cord shapes were straighter, and the cervical spine length/height and cervical spinal cord length/height ratios were significantly higher than those of the height-matched male group. In the female group, the cervical spine and cervical spinal cord shapes were similar to the patient group; however, the cervical spine length/height and spinal cord length/height ratios as well as the heights were significantly smaller than those of the patients.
The cervical spinal cords of the patients were considered to be stretched even with the neck in neutral position, reflecting disproportion of the cervical spine and spinal cord. The shorter length of the cervical spine and spinal cord in females was suspected to be one of the reasons for the marked male preponderance.
颈椎屈曲型脊髓病是一种相当罕见的疾病，主要影响出现上肢肌肉萎缩的青春期男性。其病因仍然不明，其明显的男性优势原因也不明。颈椎与脊髓比例失调被怀疑是病因之一，然而，这一点尚未得到证实。
我们对6例青少年颈椎屈曲型脊髓病男性患者和34名年轻正常对照者的颈椎磁共振（MR）图像进行了对比研究。
在正常对照者中，高个男性的颈椎和脊髓比矮个男性更直，女性比男性更直。在这些患者中，颈椎和脊髓形状更直，颈椎长度/高度和颈脊髓长度/高度比值显著高于身高匹配的男性组。在女性组中，颈椎和颈脊髓形状与患者组相似；然而，颈椎长度/高度和脊髓长度/高度比值以及身高显著小于患者。
即使颈部处于中立位，患者的颈脊髓也被认为处于拉伸状态，这反映了颈椎与脊髓比例失调。女性颈椎和脊髓较短的长度被怀疑是明显男性优势的原因之一。
