Does the sagittal alignment of the cervical spine have an impact on disk degeneration? Minimum 10-year follow-up of asymptomatic volunteers
Does the sagittal alignment of the cervical spine have an impact on disk degeneration? Minimum 10-year follow-up of asymptomatic volunteers
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DOI：
10.1007/s00586-009-1095-5
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发表时间：
2009-11-01
影响因子：
2.8
通讯作者：
Takahata, Takeshi
中科院分区：
文献类型：
--
作者：
Okada, Eijiro;Matsumoto, Morio;Takahata, Takeshi
很少有研究调查并阐明颈椎退行性变的进展与矢状面排列之间的关系。本研究的目的是纵向评价健康受试者颈椎退行性病变的进展与年龄、临床症状的发展和颈椎矢状面对齐之间的关系。在1994年至1996年期间接受颈椎MRI和X线平片检查的497名无颈椎病志愿者中，有113名（45名男性和68名女性）对我们的联系人做出了回应。所有受试者在初始研究后平均11.3年再次接受MRI。初次成像时的平均年龄为36.6 ± 14.5岁（11-65岁）。MRI评价的项目为（1）椎间盘信号强度降低，（2）椎间盘后突出，（3）椎间隙狭窄。每个项目都使用数字评分系统进行评估。受试者根据年龄和颈椎矢状排列分为四组，即，40岁以下或40岁以上的受试者，以及颈椎矢状位排列的前凸或非前凸类型的受试者。在10年期间，分别有64.6%、65.5%和28.3%的受试者出现椎间盘信号强度下降、椎间盘后部突出和椎间盘间隙变窄的进展。在40岁以上的非脊柱前凸型矢状排列的受试者中，椎间盘后突的进展明显更常见。Logistic回归分析显示，女性患者肩关节僵硬程度最高（P = 0.001），上肢麻木程度与年龄（P = 0.030）和男性（P = 0.038）相关。然而，颈椎的矢状面排列与临床症状之间没有显著的相关性。随着年龄的增长，颈椎的骶椎对线对颈椎退行性病变的进展有一定的影响;但是，它与未来临床症状的发生无关。
There have been few studies that investigated and clarified the relationships between progression of degenerative changes and sagittal alignment of the cervical spine. The objective of the study was to longitudinally evaluate the relationships among progression of degenerative changes of the cervical spine with age, the development of clinical symptoms and sagittal alignment of the cervical spine in healthy subjects. Out of 497 symptom-free volunteers who underwent MRI and plain radiography of the cervical spine between 1994 and 1996, 113 subjects (45 males and 68 females) who responded to our contacts were enrolled. All subjects underwent another MRI at an average of 11.3 years after the initial study. Their mean age at the time of the initial imaging was 36.6 +/- A 14.5 years (11-65 years). The items evaluated on MRI were (1) decrease in signal intensity of the intervertebral disks, (2) posterior disk protrusion, and (3) disk space narrowing. Each item was evaluated using a numerical grading system. The subjects were divided into four groups according to the age and sagittal alignment of the cervical spine, i.e., subjects under or over the age of 40 years, and subjects with the lordosis or non-lordosis type of sagittal alignment of the cervical spine. During the 10-year period, progression of decrease in signal intensity of the disk, posterior disk protrusion, and disk space narrowing were recognized in 64.6, 65.5, and 28.3% of the subjects, respectively. Progression of posterior disk protrusion was significantly more frequent in subjects over 40 years of age with non-lordosis type of sagittal alignment. Logistic regression analysis revealed that stiff shoulder was closely correlated with females (P = 0.001), and that numbness of the upper extremity was closely correlated with age (P = 0.030) and male (P = 0.038). However, no significant correlation between the sagittal alignment of the cervical spine and clinical symptoms was detected. Sagittal alignment of the cervical spine had some impact on the progression of degenerative changes of the cervical spine with aging; however, it had no correlation with the occurrence of future clinical symptoms.