| 青年颈椎失稳临床症状及影像学表现探讨 |
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Received:May 31, 2022
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| 作者 | Author | 单位 | Unit | E-Mail |
| 路广琦 |
LU Guang-qi |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 庄明辉 |
ZHUANG Ming-hui |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 常晓娟 |
CHANG Xiao-juan |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 朱立国 |
ZHU Li-guo |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
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| 于杰 |
and YU Jie |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100102, China |
doctoryujie@aliyun.com |
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| 期刊信息：《中国骨伤》2022年35卷，第12期，第1148-1153页 |
| DOI：10.12200/j.issn.1003-0034.2022.12.008 |
| 基金项目:国家自然科学基金（编号：82074455）；中国中医科学院科技创新工程（编号：CI2021A02002） |
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目的：探讨以在读医学硕博研究生为代表的青年人群颈椎失稳相关临床症状及X线影像学特征。
方法：自2021年9月至12月对91例在读医学硕博研究生进行调查研究，其中男45例，女46例；年龄22~30（25.30±2.18）岁。收集受试者颈椎病相关不适症状，并由检查医师对其进行颈肩部压痛点检查和颈椎正侧位及功能位X线片拍摄，并根据X线检查结果将受试者分为颈椎非失稳组和失稳组进行比较。
结果：91例受试者中，共有50例颈椎失稳者，占受试者总数的54.90%；颈椎曲度异常者78例，占受试者总数的85.70%。在50例颈椎失稳受试者中，共有50例以椎体角度位移≥ 11°为诊断依据而被诊断为颈椎失稳，其中，C3，4失稳者13例，C4，5失稳者30例，C5，6失稳者7例；共有5例以椎体水平位移≥ 3.5 mm为诊断依据而被诊断为颈椎失稳，其中，C3，4失稳者1例，C4，5失稳者4例。两组比较，失稳组颈痛、头痛、肩痛不适症状阳性表现人数明显多于非失稳组（P<0.05）；失稳组C4，5棘突间隙、C5，6棘突间隙、C2-C5棘突旁开2 cm和肩胛骨上角（肩胛提肌止点）位置压痛表现人数明显多于非失稳组（P<0.05）；失稳组颈椎曲度明显小于非失稳组（P<0.05）。
结论：以在读医学硕博研究生为代表的青年人群颈椎失稳发生率较高，失稳者以椎体角度位移≥ 11°为诊断依据而被诊断为颈椎失稳为主，其失稳节段集中在C3，4、C4，5、C5，6 3个节段，颈椎失稳的发生常伴随颈椎曲度的异常而出现，临床表现多见头颈部和肩部疼痛，尤其是失稳节段的颈部疼痛。 |
| [关键词]:青年 颈椎 体征和症状 X线 |
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| Clinical symptoms and imaging findings of cervical instability in young adult |
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Abstract:
Objective: To explore clinical symptoms and X-ray imaging features of cervical instability in young adult represented by postgraduates with a master's degree in medicine.
Methods: Totally 91 postgraduates with a master's degree in medicine were investigated from September to December 2021, including 45 males and 46 females;aged from 22 to 30 years old with an average of (25.30±2.18) years old. The cervical spondylosis-related discomfort symptoms of the subjects were collected and examined by the examiner for neck and shoulder tenderness point examination and cervical vertebra positive and lateral and functional X-ray radiography. According to the results of X-ray examination, the subjects were divided into stable cervical group and unstable cervical group.
Results: Among 91 subjects, there were 50 patients with cervical instability, accounting for 54.90% of total number of subjects. The cervical curvature was abnormal in 78 patients, accounting for 85.70% of total number of subjects. Among 50 patients with cervical instability, 50 patients were diagnosed as cervical instability on the basis of angular displaxement(AD) ≥ 11 °, including 13 cases of C3, 4 instability, 30 cases of C4, 5 instability and 7 cases of C5, 6 instability;and 5 cases were diagnosed as cervical instability based on horizontal displacement(HD) ≥ 3.5 mm, including 1 case of C3, 4 instability and 4 cases of C4, 5 instability. Compared with stable cervical group, the number of discomfort symptoms of neck pain, headache and shoulder pain in instability group was significantly higher than that of in stable cervical group(P<0.05);and the number of tenderness in spinous process space of C4, 5 and C5, 6, 2 cm adjacent to the spinous process of C2-C5 and the superior angle of the scapula (the stop point of levator scapulae) in the instability group was significantly higher than that in the stable cervical group (P<0.05);and the cervical curvature in the instability group was significantly lower than that in stable cervical group(P<0.05).
Conclusion: The incidence of cervical instability in young adult represented by postgraduates with a master's degree in medicine is high, they are mainly diagnosed as cervical instability on the basis of vertebral angular displacement ≥ 11°, and the instability segments are concentrated on C3, 4, C4, 5 and C5, 6 segments, the occurrence of cervical instability is often accompanied by abnormalities of cervical curvature. Most of clinical manifestations are head, neck and shoulder pain, especially neck pain in unstable segment. |
| KEYWORDS:Young adult Cervical vertebrae Signs and symptoms X-rays |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 路广琦,庄明辉,常晓娟,朱立国,于杰.青年颈椎失稳临床症状及影像学表现探讨[J].中国骨伤,2022,35(12):1148~1153 |
| 英文格式: | LU Guang-qi,ZHUANG Ming-hui,CHANG Xiao-juan,ZHU Li-guo,and YU Jie.Clinical symptoms and imaging findings of cervical instability in young adult[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(12):1148~1153 |
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