科研之友
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摘要
Objective To investigate the cervical alignment and the relative range of motion (ROM) in patients with basilar invagination (BI). Methods A total of 40 BI cases (38.1 years old +/- 17.9 years old, 19 male and 21 female) and 80 asymptomatic individuals (33.8 years old +/- 10.8 years old, 40 male and 40 female) were included. The Skull-C-2/Skull-BV, Skull-C-7, C-2-C-7/BV-C-7 wall angles, C-0-C-2/C-0-BV, C-0-C-7, C-1-C-7, and C-2-C-7/BV-C-7 angles were measured in dynamic X-ray images (including neutral, extension, and flexion positions). Correlation between the upper and lower cervical curvatures were analyzed. The total, extension, and flexion ROMs of these angles were calculated, respectively. Results The BI patients had a smaller C-0-C-2/C-0-BV angle (18.2 degrees +/- 16.4 degrees vs 30.9 degrees +/- 9.3 degrees), but larger C-2-C-7/BV-C-7 (32.2 degrees +/- 16.1 degrees vs 19.4 degrees +/- 10.6 degrees) and C-2-C-7/BV-C-7 wall angles (37.8 degrees +/- 17.2 degrees vs 23.6 degrees +/- 10.2 degrees) than the control group in neutral position. The upper and lower curvatures correlated negatively in neutral (r = -0.371), extension (r = -0.429), and flexion (r = -0.648) positions among BI patients, as well as in extension position (r = -0.317) among control group. The BI patients presented smaller total ROMs in Skull-C-2/Skull-BV (12.3 degrees +/- 16.6 degrees vs 19.7 degrees +/- 10.9 degrees), C-0-C-2/C-0-BV (8.1 degrees +/- 11.1 degrees vs 17.6 degrees +/- 10.5 degrees), and C-0-C-7 angles (57.8 degrees +/- 14.2 degrees vs 78.3 degrees +/- 17.9 degrees), but a larger total ROM in C-2-C-7/BV-C-7 wall angle (52.8 degrees +/- 13.9 degrees vs 27.0 degrees +/- 16.1 degrees) than the control group. The BI patients also presented smaller extension ROMs in Skull-C-2/Skull-BV (6.9 degrees +/- 9.4 degrees vs 12.5 degrees +/- 9.3 degrees), Skull-C-7 (24.5 degrees +/- 10.9 degrees vs 30.7 degrees +/- 12.5 degrees), and C-0-C-2/C-0-BV angles (4.4 degrees +/- 7.8 degrees vs 9.9 degrees +/- 8.6 degrees) than the control group. Moreover, the BI patients showed smaller absolute values of flexion ROMs in Skull-C-2/Skull-BV (-5.2 degrees +/- 9.4 degrees vs -7.3 degrees +/- 8.0 degrees), C-0-C-2/C-0-BV (-3.2 degrees +/- 8.8 degrees vs -7.7 degrees +/- 8.7 degrees), and C-0-C-7 angles (-33.2 degrees +/- 13.0 degrees vs -52.8 degrees +/- 19.2 degrees), but a larger absolute value of flexion ROM in C-2-C-7/BV-C-7 wall angle (-33.9 degrees +/- 14.8 degrees vs -8.2 degrees +/- 15.1 degrees). Conclusion The cervical spine was stiffer in BI patients than the asymptomatic individuals, especially in the upper cervical curvature. The negative correlation between upper and lower cervical curvatures was more obvious in BI patients.
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单位南方医科大学
