| Research purpose:1.The use of digital Department of orthopedics system,parameters of observation of normal Chinese cervical intervertebral foramen morphology and imaging,through statistical analysis of related parameters,processing parameters,the reference range of normal adult,s the intervertebral foramen,making the foraminal stenosis standard,and provide the basis for the study of nerve root type cervical spondylosis of the next step.2.Study on the parameters to the patient through the nerve root type of cervical spondylosis of intervertebral foramen and related images,the symptoms and signs,to investigate the morphology of C5/6 cervical intervertebral foramen,the correlation between the parameters and the nerve root type cervical spondylosis related imaging,provide the basis for the decompression of the nerve root type cervical spondylosis and the degree,at the same time as the further development of cervical spinal canal stenosis diagnosis standard and nerve root type cervical surgical indications for reference.Research method:Normal group: 191 healthy persons,95 males,96 females,.The same proportion of male and female.Recuitment conditions :(1)The age was 18-60 years with normal development of the body;(2)Without the head,neck and shoulder trauma;(3)No previous history of neck and shoulder soreness,pain and limitation of activity,no upper limb pain,numb,foot step cotton,gait instability and other common symptoms of cervical spondylosis;(4)The neck and shoulder activity is normal,no tenderness,no percussion pain,negative pressure neck test,brachial plexus traction test negative,no loss of muscle strength,muscle tension without limbs reflex and increased normal tendon reflex,warm touch shallow feeling pain and the location of sleep deep feel no loss,Hoffmann,Barbinskin and other pathological signs negative;(5)Standard X-ray lateral position,and double oblique cervical curvature show intervertebral disc height,and intervertebral foramen is not abnormal?Case study group: Our hospital inpatient and outpatient 246 cases,123 males and 123 females,The same proportion of male and female.Recuitment conditions :(1)There are symptoms such as swelling of the neck and shoulder,pain and discomfort,upper limb pain,numbness of upper limb or hand;(2)The age was 18-60 years with normal development of the body;(3)Neck and shoulder activity degree is limited,can have tenderness,percussion pain,a neck pressure test positive,brachial plexus traction test positive,upper limb soreness,pain,numbness,muscle strength can be decreased,muscle tension can increase,limbs reflex,tendon reflexes hyperfunction or normal limbs,warm touch,pain and other shallow the feeling can be decreased,Hoffmann,Barbinskin and other pathological negative syndrome;(4)Standard X-ray lateral position,and double oblique cervical curvature show intervertebral disc height,and intervertebral foramen is abnormal ?Methods:The cervical X-ray of the normal adult group and the case study group is lateral,integration,double oblique and cervical CT 3D images of multi angle,multi dimensional observation of bilateral cervical intervertebral foramen intervertebral foramen shape,measuring longitudinal diameter,diameter before and after,before and after mean diameter,transverse diameter,cross-sectional area,bone osteophytes form,intervertebral disc height and mean height of anterior and posterior margin.Result:1.The morphology and imaging parameters of the intervertebral foramen in the normal adult groupCervical X-ray lateral,oblique,cervical CT 3D reconstruction showed that the morphology of the same sequence of bilateral cervical intervertebral foramen has no obvious difference.C2/3 intervertebral foramen was always round and the morphology of C3/4,C4/5,C5/6,C6/7 intervertebral foramen,was approximate ellipse.In addition to the two forms of appeal,intervertebral foramen can be crescent,spindle the flask shaped,irregular shape,etc..The morphology of intervertebral foramen was closely related to diameter of the intervertebral foramen,osteophyte morphology,anterior and posterior height of intervertebral disc.The longitudinal diameter of intervertebral foramen of normal adult group decreased with increasing sequence of cervical intervertebral foramen.The longitudinal diameter of intervertebral foramen from C2/3 to C6/7 was 12.960 ± 2.36 mm,12.710 ± 1.866 mm,12.160 ±1.641 mm,11.660 ± 1.936 mm and 11.500 ± 2.388 mm.In the same intervertebral foramen,anterior posterior diameter of the lower value before and after the size of the two values are relatively smaller than vertical diameter.The mean of transverse diameter of C2/3 was bigger than others,The mean of transverse diameter increased with the sequence increased,and then decreased with increasing sequence.The mean of transverse diameter from C2/3 to C6/7 was 8.797± 1.527 mm,6.746 ± 0.902 mm,7.878±1.423 mm,7.599±1.366 mm and 7.572 ±1.251 mm.The intervertebral foramen area to the maximum at C2/3,C3/4 to C6/7 intervertebral foramen area increased with increasing sequence,after the sequence increases,the cross-sectional area of the intervertebral foramen C2/3 to C6/7 were 88.870±22.76mm2,71.800±19.41mm2,78.290±19.12mm2,72.800±22.48mm2,66.210 ±20.92mm2.There was significant difference between the different diameter and the cross section of the intervertebral foramen.2.The correlation between the morphology of cervical intervertebral foramen and the imaging parameters of cervical spondylosisIn patients with cervical spondylosis,There was no significant difference between the intervertebral foramen without symptoms corresponding to the morphology of the left and right side,and there is no obvious difference with normal people,but there were symptoms of the corresponding intervertebral foramen morphology due to osteophyte formation,ligament calcification,facet joint hyperplasia causes irregular stenosis,much now the spindle,most of which C5/6,corresponding to the cervical vertebra disease predilection segment.And when the corresponding intervertebral foramen stenosis due to cervical instability,facet hypertrophy,cervical fracture and secondary intervertebral foramen stenosis,one side may be no obvious clinical symptoms,but with a series of bilateral intervertebral foramen were changed.The intervertebral foramen longitudinal diameter of case study group had no significant difference with normal adult group,there decreased with the increase of intervertebral sequence,The intervertebral foramen longitudinal diameter from C2/3 to C6/7 diameter was 14.19±2.246 mm,11.465 ±1.854 mm,11.370 ±1.668 mm,10.445 ±1.682 mm,10.427 ±1.461 mm,the difference of the longitudinal diameter was not statistically significant(P<0.05).The intervertebral foramen diameter without stenosis with the normal adult group had no significant difference,all decreased with the increase of sequence.In the cervical stenosis intervertebral foramen,C5/6 was in the most.The mean diameter was 4.634 ±1.028 mm,diameter smaller than the normal control group,compared with the normal adult group,there was statistical significance in C5/6(P<0.05),Stenosis of the intervertebral foramen do with to transverse cervical intervertebral foramen size significantly;Mean cross-sectional area of C5/6 intervertebral foramen stenosis was 34.765±10.275mm2,compared with the normal group,the difference was statistically significant(P<0.05).The stenosis of intervertebral foramen at the entrance of uncovertebral joint and hyperplasia in rear facet joint hyperplasia also share proportion.At the same time,the mean intervertebral disc height of the anterior and posterior margin in the narrow segment was smaller than that of the normal adult group,the mean height of the intervertebral disc in the normal group was 5.765±0.947 mm,and the mean height of the intervertebral disc in the case group was 4.973± 0.884 mm,and the difference was statistically significant(P<0.05).ConclusionIn the normal adult group,the intervertebral foramen morphology and relevant imaging parameters in different segments are not the same,nearly all C2/3 intervertebral foramen was round,other segments were nearly oval.The longitudinal diameter,transverse diameter and cross-sectional area were decreased with the increase of cervical sequence.In case study group.Cervical intervertebral foramen stenosis segment in the form similar to the normal group in the narrow segment int C5/6,fusiform was the most common form,andvertical diameter of intervertebral foramen has no obvious change,and the mean diameter of foraminal width and cross-sectional area decreased significantly,while the stenosis of intervertebral foramen was greatly related to uncovertebral joint hyperplasia,hypertrophy of the facet joints,intervertebral foramen height loss.It provides the basis for the scope and extent of surgical decompression,and provides a reference for the formulation of the relevant surgical indications of cervical spondylotic myelopathy. |
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