The Orientation Of The Articular Facets Of The Zygapophyseal Joints At The Cervical In Normal Adult Human And The Clinic Relationship With Cervical Syndrom

Objective:the incidence rate of the cervical syndrome may be about 4%~16% in Chinese human. On the cross section of cervical vertebra,we called the included angle that the orientation of the zygapophyseal joints through the perpendicular line of cervical vertebra body's biggest transverse diameter the orentation or direction of cervical articular facets. The study was undertaken on measuremented the orientation of the articular facets from 130 adult human vertebral columns,to knowledge normal human's orientation of facet joints of C3~C7 the appearance distribute characteristics and variation degree, further study the clinical relationship between the direction and cervical vertebra disease.Methods: The sample number is 130, all clinical cases sa- mples were choosen from the third Hospital of Hebei Medical university .Choice the out-patient service seek medical advice caase 25, the standard is requesting for only the tiny symptom in neck, have no obvious ache numbness, have no arms and legs symptom, and after clinically and image exactly learn excepted cervical vertebra congenital abnormality,tumor,phymatiosis, bone fracture, cervical vertebra syndrom as normal adult's group,among them male 12, female 18, the age is 22~53 years old, the average age is 39.7 years old.Choose out-patient service or hospitalization case 100, the standard is for all through cev- ical MRI or CT check with detailed check-up and combine the clinical symptom to confirm for the cervical syndrom patient's, excluded the other neck disease of the cervical vertebra tumor,phymatiosis,bone fracture...etc. we call it as a case research group, among the male 71, the female 29.The age is between 32~70 years old and the average is 52.6 years old.The involved segment include:C3,4 is 13 cases, C4,5 is 58 cases, C5,6 is 75 cases, C6,7 is 13cases, among them, the single segment involved is 54 cases, the double segment is 33, the triple and above to be involved is 13 cases. The scaning method as the normal adult's group, take each cervical vertebra upper-endplates surface with it parallelism of MRI or CT cross section, from C2~C7.First time measure on MRI or CT slice used measurement tool,and second measurement we imported the recorded picture to computer, made use of photo measurement software respectively measured all the two side of cervical orientation of the articular facets.At last we adopted the statistics software SPSS to analysised thses datas.Results:1,For all the examination's subjective error,we detected the error margin of main source is to assurance the vertebra margin and to definition the boundary of joint top and bottom in picture, but straight line related coefficient examination result indicated both have strong relativity.Above-mentioned result enunciated original research adoption of this measurement the method have higher re-usable and credibility.2,The two side of cervical orientation of the articular facets in normal adult's group.The side influence:Each segment cervical vertebra surface of measurement result detected respectly diffently, but in same level the two sides comparison result manifested having no obvious side advantage.All level in the cervical vertebra, the T examination result in the same segment manifested:the comparison result between two side articular facets joint had no significance(P>0.05).But in normally, the average dissymmetry degree between two side is about 17.2%, especialy in C5,6,about32%.This means the orientation of the articular facets of the zygapophyseal joints at the cervical in normal adult human have no side advantage at each segment.The orientation of the articular facets of the zygapophyseal joints at the cervical in normal adult human of different segment:After comparison among the different segment cervical articular facets, we detected the angle difference of the each segment showing significant difference.The angle of the cervical vertebra articular facets joint is between 54~85°in C2,3,to deliver backward outside with sagittal plane.In C3,4 level at the neck, the angle is between 72~110°.At C 4,5 the angle is between 78~117°, C5,6 is between 86~120°, so from the C3,4 in to the C5,6 transition process, the angle is gradual enlargement, gradually changing from backward outside become to direction to present level, or change direction level forward of angle, assumly more and more to forward outside.But at C6,7 in the neck, its angle is between 83~105°, then after C6,7 vertebra body, because of gradually changing thoracic vertebrae, the angle of the orientation of the articular facets of the zygapophyseal joints at the cervical gradually diminished, present close level direction, namely the angle of the orientation of the articular facets of the zygapophyseal joints gradually from forward return to horizon level,and reciprocal adaptation with thoracic vertebrae.And between the C4~C7 of transition stanza segment, the angle of cervical vertebra articular facets joint two kinds of form is lord, from here we can divide cervical vertebra articular facets joint in to gradually change and sudden change type.3,The clinical relation between the orientation of the articular facets of the zygapophyseal joints at the cervical and cervical syndrome.Among the cervical syndromes,Appear pathological changes segment the orientation of the articular facets joint of the one side,more persons are in normally the scope, but the other a side can or perhaps is not in the normally scope.In all the segments, the T test result showed that the double side orientation of the articular facets joint of dissymmetry wtih cervical vertebra disease of occurrence have no obvious relativity.But in C4-6,because the probility of dissy- mmetry is more than others,and the segments are the most involvement,so we consider the dissymmetry having determinered relationship with cervical disease.Conclusions: In the normal dult the cervical vertebra, each the orientation of the articular facets emergenced different characteristics.Top cervical vertebra with skull bone of the conjunction way come to a decision the direction of close together cervical vertebra joint angle.Medium cervical vertebra of dissimilarity direction of bend to stretch, revolve, the wreath turn etc. complications sport again come to a decision this parts of cervical vertebra the orientation of the articular facets of characteristics.Cervical vertebra and thoracic vertebrae move a line a conjunction to come to a decision cervical vertebra the orientation of the articular facets of angle characteristic.In the cervical vertebra the patient the matched control of detection, occurrence no pathological changes of the the orientation of the articular facets angle of segment all at normal scope inside, but the same level of the orientation of the articular facets of obvious dissymmetry more easy suffer from neck disease, especially in C4~6 in the neck .On the whole, the articular facets of the zygapophyseal joints at the cervical are of one importance structures in the spinal column, having significant effection in keeping spinal stability and movable ability, the orientation of the articular facets of the zygapophyseal joints at the cervical in normal adult human are determined by special movement of cervical vertebra,and the orientation of the articular facets of the zygapophyseal joints at the cervical have some meanings among the procession of cervical syndromes.