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目的通过对颈椎矢状位参数的MRI测量,分析不同矢状位曲度状态下的脊髓型颈椎病患者各主要颈椎矢状位参数之间的相关性,从而找出具有代表意义的颈椎矢状位参数。方法回顾性分析2015年7月—2016年1月因脊髓型颈椎病就诊的88例患者资料,于颈椎矢状位MRI T_2加权像上测量C_2~C_7 Cobb角、T_1倾斜角(T_1 slope,T_1S)及C_2~C_7矢状位轴向距离(C_2~C_7 sagittal vertical axis,C_2~C_7 SVA)。根据C_2~C_7 Cobb角大小不同将患者分为前凸组(Cobb角≥10°,48例)及变直组(Cobb角0~10°,40例)。数据测量可靠性采用组内相关系数(intraclass correlation coefficient,ICC)表示,各影像学参数的相关性检验采用Pearson相关进行分析。结果颈椎各参数的ICC为0.858~0.946,组内测量一致性良好。变直组C_2~C_7 Cobb角为(5.6±2.4)°,T_1S为(22.2±6.7)°,C_2~C_7 SVA为(10.2±5.4)mm;前凸组C_2~C_7 Cobb角为(20.1±8.2)°,T_1S为(23.4±8.9)°,C_2~C_7 SVA为(8.2±4.6)mm。变直组3个参数间均无相关性,其中T_1S与C_2~C_7 Cobb角(r=0.100,P=0.510);T_1S与C_2~C_7SVA(r=–0.100,P=0.500);C_2~C_7 Cobb角与C_2~C_7 SVA(r=0.080,P=0.610)。前凸组T_1S与C_2~C_7 Cobb角之间成正相关(r=0.540,P=0.000),T_1S与C_2~C_7 SVA之间成负相关(r=–0.450,P=0.001),C_2~C_7 Cobb角与C_2~C_7SVA之间无相关性(r=–0.003,P=0.980)。结论具有颈椎生理前凸的脊髓型颈椎病患者,可仅以MRI测量的T_1S值作为评判矢状位曲度的主要参数代表;而对于颈椎生理前凸变直患者,需要T_1S、C_2~C_7 Cobb角、C_2~C_7 SVA进行测量来综合评判。
Objective To study the correlation between sagittal parameters of sagittal cervical spondylotic myelopathy patients under different sagittal curvature by MRI measurement of cervical sagittal parameters so as to find the representative cervical sagittal Bit parameters. Methods The data of 88 patients with cervical spondylotic myelopathy from July 2015 to January 2016 were retrospectively analyzed. C_2 ~ C_7 Cobb angle, T_1 slope, T_1S ) And axial distance of C_2 ~ C_7 sagittal (C_2 ~ C_7 sagittal vertical axis, C_2 ~ C_7 SVA). According to the size of C_2 ~ C_7 Cobb angle, the patients were divided into the convex group (Cobb angle ≥10 °, 48 cases) and straightening group (Cobb angle 0 ~ 10 °, 40 cases). The reliability of data measurement was expressed as intraclass correlation coefficient (ICC), and correlation of each imaging parameter was analyzed by Pearson correlation. Results The ICC of each parameter of cervical spine was 0.858 ~ 0.946, and the consistency of measurement in the group was good. The Cobb angle of C_2 ~ C_7 was (5.6 ± 2.4) °, (22.2 ± 6.7) ° and (C_2 ~ C_7) SVA was (10.2 ± 5.4) mm respectively in the straightening group and (20.1 ± 8.2) ) °, T_1S was (23.4 ± 8.9) °, and C_2 ~ C_7 SVA was (8.2 ± 4.6) mm. There was no correlation between the three parameters of T_1S and C_2 ~ C_7 (r = 0.100, P = 0.510); T_1S and C_2 ~ C_7SVA (r = -0.100, P = 0.500); C_2 ~ C_7 Cobb Angle and C_2 ~ C_7 SVA (r = 0.080, P = 0.610). There was a positive correlation between T_1S and C_2 ~ C_7 SVA (r = -0.450, P = 0.001), C_2 ~ C_7 Cobb angle (r = 0.540, P = 0.000) There was no correlation between angle and C_2 ~ C_7SVA (r = -0.003, P = 0.980). Conclusions Patients with cervical spondylotic myelopathy with cervical lordosis can only represent the T 1 S value measured by MRI as the main parameter for evaluating sagittal curvature. For patients with cervical lordosis, T 1 S, C 2 -C 7 Cobb Angle, C_2 ~ C_7 SVA to measure the comprehensive evaluation.