骨质疏松合并颈椎病的颈椎影像学及骨密度变化

目的 探讨骨质疏松合并颈椎病时颈椎影像学及骨密度变化之间的关系。方法 分3组，正常组20例，平均年龄23岁；颈椎间盘突出症组（颈椎组）18例，平均年龄43岁，桡骨骨密度正常，行颈椎前路手术；骨质疏松合并颈椎管狭窄症组（疏松组）25例，平均年龄59岁，桡骨骨密度低于正常，行颈椎后路手术，所有病例测量颈椎侧位C3－C6的椎管、椎体矢状径比，椎体变形指数，C4－C6骨密度。数据进行统计学处理。结果 与正常组相比，颈椎组患仅在C5，C6椎体出现轻度椎管狭窄，椎体变形，骨密度无明显变化；疏松组则是颈椎广泛椎管狭窄，椎体变形，骨密度升高，三值之间有较明显的相关性。结论 颈椎骨质疏松可能是颈椎开始退变进而发展为颈椎病的始动因素之一，C5，C6椎体最早发生椎体变形，椎管狭窄，以后逐渐扩大至其他椎体，椎体周围骨增生使椎体骨密度升高。

Radiograms and bone density variation of cervical spondylosis patients associated with osteoporosis in cervical vertebrae

AIM To study the relationship between cervical spondylosis and osteoporosis in the cervical spine. METHODS The subjects were separated into three groups. Twenty healthy subjects, 23 years of average age, were in Normal Group (NG); Eighteen patients, 43 years of average age, with herniation of cervical disc and normal bone density of radius, were in Herniation of cervical disc Group (HG); And twenty five patients, 59 years of average age, with spinal canal stenosis and subnormal bone density of radius, were in Osteoporosis in association with spinal canal stenosis Group (OG). The sagittal diameter ratio of the cervical canal vertebral body and the cervical canal vertebral body and the deformation index of the cervical vertebral body from C 3 to C 6, the bone density from C 4 to C 6 of all subjects were measured. The data were statistically analyzed. RESULTS The slight spinal canal stenosis and the deformation of vertebral body occurred in C 5, C 6 in HG compared with NG, but there was no significant difference in the bone density between the two groups. The wide range spinal canal stenosis, the deformation and increasing bone density of the vertebral body were present in the patients in OG; moreover, the significant correlation was found between both of the three indexes. CONCLUSION Osteoporosis may be one of the initiative factors leading to the degeneration of the cervical spine developing into cervical spondylosis in the cervical spine. The deformation and spinal canal stenosis firstly commence on the vertebral body of C 5, C 6 being in a hyperkinetic position, and progressively develop over all of the cervical vertebral body. The deformation and widened transverse diameter of vertebral body, the porous and the hyperosteogeny lead to the increasing bone density of vertebral body.