| Objective: The purpose of this study is to explore the relationship between the direction of facet joint and the degenerative instability of cervical spine in C4~ C5 segment by measuring the angles of facet joints in C3 ~ C4,C4~ C5,C5 ~ C6 and C6 ~ C7 segments in sagittal and transverse planesMethods: From HIS system of the hospital,the imaging examination results of 562 cases in orthopedics department of our hospital from July 2011 to July 2019 were collected for retrospective study.A total of 416 cases had the imaging examination data such as Dr of cervical spine,Dr of cervical hyperextension and flexion,and 3D spiral CT,among which 40 cases were only C4~ C5 patients with degenerative instability were treated as the observation group,46 age and gender matched patients without degenerative lower cervical instability as the control group.The P-F angles of C3 ~ C4,C4 ~ C5,C5 ~ C6 and C6 ~ C7 were measured on the lateral plain film,and the angles of the left and right facet joints of C3-C7 were measured on the transverse plane of the three-dimensional spiral CT plain scan,and the obtained parameters were analyzed to determine the differences between the two groups.Results: The P-F angle of the upper segment of C4 ~ C5 in the observation group was significantly higher than that in the control group(P < 0.05),and the mean value of 135.72 ° in the observation group was significantly higher than that of 130.71 ° in the control group.On the C5 ~ C6 segment,the P-F angle of the observation group and the control group was also different(P < 0.05).The P-F angle of the observation group was 131.42 ° higher than that of the control group,129.6 °.In the control group,the P-F angles of C3 ~ C4,C4 ~ C5 and C5 ~ C6 segments were larger than those of C6 ~ C7 segments.In the observation group,the P-F angles of C3 ~ C4,C4 ~ C5,C5 ~ C6 and C6 ~ C7 were also statistically different,and the order of the P-F angles of the four segments was C4 ~ C5 > C3 ~ C4 / C5 ~ C6 > C6 ~ C7.The analysis of facet joint angles measured on plain 3d spiral CT showed that there was no difference in the left and right facet joint angles of each segment of C3 ~ C4,C4 ~ C5,C5 ~ C6 and C6 ~ C7 in the control group and the observation group(P>0.05).The difference of facet joint asymmetry between the two groups at C4 ~ C5 segments was statistically significant.The mean degree of facet joint asymmetry between the observation group and the control group was 10.77° and 6.59°,respectively,while there was no difference in facet joint asymmetry between the two groups at other segments.In the control group,there was no difference in facet joint asymmetry between C3 ~ C4,C4 ~ C5,C5 ~ C6 and C6 ~ C7.In the observation group,the facet joint asymmetry of C4 ~ C5 segments was significantly stronger than that of C3 ~ C4,C5 ~ C6 and C6 ~ C7 segments(C4 ~ C5 and C3 ~ C4,P <.001).C4 ~ C5 and C5 ~ C6,P =0.001;C4 ~ C5 and C6 ~ C7,P <.001)Conclusion:This study is the first to explore the relationship between the direction of the facet joint on the transverse and sagittal plane and the C4 ~ C5 degenerative lower cervical instability.The results show that the angle of P-F in sagittal plane is the largest in C4 ~ C5 segment on Dr lateral radiograph of cervical spine.With the increase of the angle of P-F in C4 ~ C5 and C5 ~ C6 segment,that is to say,it tends to be horizontal,the risk of cervical instability is higher.It can be observed that the joint angle of the left and right facets of each segment of the cervical spine is close to the coronal plane,which may be related to the large range of cervical spine movement.The absolute value of the difference between the left and right sides of C4 ~ C5 segments is significantly greater than that of other segments,indicating that the greater the asymmetry of the facet joint,the greater the risk of degenerative lower cervical instability... |
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