| Objective: To measure the angle of cervical vertebral lamina and explore its relativity with developmental spinal stenosis and cervical spondylotic myelopathy and its application and clinical significance in cervical spondylotic myelopathy. To search another quantitative indicator on determining the degree of cervical spondylotic myelopathy and provide a clinical reference to evaluate the function of patients with cervical spondylotic myelopathy and surgical treatment.Methods:1 Collect 10 dried samples of C3-C6. Scan with CT and measure its angles with the upper and lower laminectomy.Komogorov-smimov was used to test whether it is normal distribution.The relativity analysis of its result and sagittal diameter of the ratio of spinal canal/spine and sagittal diameter of spinal canal was conducted by adopting linear Pearson or Spearman analysis with two variables.2 The C3-C6 angle of cervical vertebral lamina, sagittal diameter of the ratio of spinal canal/spine with X ray, sagittal diameter of the ratio of spinal canal/spine and sagittal diameter of spinal canal with CT of 15 cases of patients with no cervical spondylosis were collected. Of the 15 cases, 8 were males, 7 were females, aged between 35-76, with an average age of 56.1.Komogorov-smimov was used to test whether the result is normal distribution.The relativity analysis of the angle of cervical vertebral lamina, sagittal diameter of the ratio of spinal canal/spine with X ray, sagittal diameter of the ratio of spinal canal/spine, and sagittal diameter of spinal canal with CT were conducted by adopting linear Pearson or Spearman analysis with two variables. Levene test was adopted to analyze gender differences on cervical vertebral lamina. Homogeneity of variance and t-test of single sample of the average value of male and female cervical vertebral lamina were used. One-Way ANOVA analysis was used to test the differences of cervical vertebral lamina of each column and the result was compared one to one.3 The angle of C3-C6 cervical vertebral lamina sagittal diameter of the ratio of spinal canal/spine with X ray, sagittal diameter of the ratio of spinal canal/spine and sagittal diameter of spinal canal with CT of 60 cases of patients with cervical spondylotic myelopathy were collected. Of the 60 cases, 32 were males, 28 were females, aged between 33-73, with an average age of 54.05. Komogorov-smimov was used to test whether the result is normal distribution.The relativity analysis of the angle of cervical vertebral lamina and sagittal diameter of the ratio of spinal canal/spine with X ray, sagittal diameter of the ratio of spinal canal /spine and sagittal diameter of spinal canal with CT were conducted by adopting linear Pearson or Spearman analysis with two variables. Levene test was adopted to analyze gender differences on cervical vertebral lamina. Homogeneity of variance and t-test of single sample of the average value of male and female cervical vertebral lamina were used. Linear Pearson or Spearman test with two variables was used to analyze the relativity of of cervical vertebral lamina and JOA.4 Levene test was used among all cases to test the mean value of homogeneity of variance of cervical vertebral lamina. T-test of single sample of the average value of male and female cervical vertebral lamina was used. Single sample t-test of mean value of patients with no cervical spondylosis and cervical spondylotic myelopathy was used. With CT ratio as its independent variable and cervical vertebral lamina as its dependent variable, linear regression analysis was conducted to analyze the linear relationship of two variables between patients with no cervical spondylosis and cervical spondylotic myelopathy.5 SPSS19.0 software was used to process all the data which were represented with meanx± standard deviation S. If the value P is less than 0.05, it is statistically significant.Results:1 Measurement results of samples:cervical vertebral lamina sagittal diameter of the ratio of spinal canal/spine with CT, a/b=0.978±0.035,cervical vertebral sagittal diameter of spinal canal with CT was a=14.220±0.369,the angle with upper lamina was α1=96.630°±2.691°,the angle with lower lamina was α2=86.545°±5.444° with a mean value of α=91.588°±3.385°.a/b,α2、α were negatively correlated. The values of r were-0.947、-0.903 and close to 1 which showed great reliability.2 Measurement results of persons with no cervical spondylosis:cervical vertebral sagittal diameter of the ratio of spinal canal /spine with X ray was a/b=0.945±0.059,cervical vertebral sagittal diameter of the ratio of spinal canal/spine with CT was a/b=0.840±0.059,cervical vertebral sagittal diameter of spinal canal with CT was a=13.593±1.144. The angle of lamina was α=97.103°±2.364°. The value a/b of X ray, value a/b of CT, value a of CT and α were negatively correlated, the values of r were-0.843,-0.751 and-0.33. The absolute value of r was 0.33 which was lower than 0.4, showing low reliability.The mean values of α were males and females were 97.43°±2.22°and 96.73°±2.50°,the comparative lamina difference between males and females P=0.252 which demonstrated no significant difference between them.The value of C3-C6 lamina p was more than 0.428 and less than 1 under One-way Anova analysis which showed no statistical significance.3 Measurement results of patients with cervical spondylotic myelopa- thy:cervical vertebral sagittal diameter of the ratio of spinal canal/spine with X ray was a/b=0.780±0.092,cervical vertebral sagittal diameter of the ratio of spinal canal/spine with CT was a/b=0.689±0.084,cervical vertebral sagittal diameter of spinal canal with CT was a=11.784±1.189.The angle of lamina was α=109.534°±7.921°. The value a/b of X ray, value a/b of CT, value a of CT and α were negatively correlated, the values of r were-0.724,-0.690 and-0.698. The mean value of α of males and females were109.16°±8.03°、109.97°±7.81°, the comparative lamina difference between males and females P=0.431 which demonstrated no significant difference between them.JOA score was 11.067±2.493,α and JOA score were negatively correlated with the value of r as-0.785.4 The average value of angles of cervical vertebral lamina of both males and females in two groups were 106.81°±8.64°、107.32°±8.84°with P=0.617, showing no statistical differences. The angles of cervical vertebral lamina of patients and persons with no cervical spondylosis were 109.53°±7.92°、97.10°±2.36°,with P=0,showing the angle of cervical vertebral lamina of patients was more than that of person with no cervical spondylosis. Pearson test was used to test the linear relationship of angles of cervical vertebral lamina with CT and the values of p of patients and persons with no cervical spondylosis was both 0 and their respective linear equations were y°=-64.961x+154.276°,y°=-29.546x+121.922°.Conclusion:1The angle of lamina α, value of a/b with X ray and value of a/b with CT were negatively correlated which can quantitatively show the degree of ossification. 2Their values were also negatively correlated with JOA scores of patients that were of great clinical significance on the function evaluation of cervical spondylotic myelopathy. 3The angles of lamina of both patients and persons with no cervical spondylosis enjoyed a linear relationship which are of a guiding role on surgical posterior cervical trapdoor technique. But this study that have deficiencies, need further research. |
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