退行性颈椎病、后凸和脊髓病患者颈椎周围肌肉的不平衡。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-02-19 DOI:10.1016/j.wneu.2024.123605

Hongwei Wang , Haocheng Xu , Xianghe Wang , Shuo Yang , Fan Zhang , Feizhou Lyu , Xiaosheng Ma , Jianyuan Jiang , Hongli Wang

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引用次数: 0

摘要

背景：测量颈椎周围肌肉力量；阐明肌肉、颈椎矢状线和脊髓型颈椎病（CSM）之间的关系；了解颈椎前凸丧失的过程。方法：对CSM患者和健康对照者的性别、年龄、病程和影像学资料进行分析。在颈椎x线片上测量C2-7 Cobb角，并在t2加权轴向磁共振图像上测量C3/4至C6/7椎间水平的深屈肌、浅屈肌（SF）、深伸肌和浅伸肌（SE）的椎体面积（VBAs）和横截面积（csa）。比较伴有和不伴有退行性颈椎后凸（DCK）的CSM患者与对照组的CSA/VBA比值。结果：CSM患者，尤其是伴有DCK的CSM患者，颈椎周围肌肉失衡。三组间C3/4水平SF/SE （P=0.036）、C6/7水平总屈肌(TF)/总伸肌（TE）（P=0.006）、C4/5水平总深肌(TD)/总浅表肌（TS）（P=0.004）、C6/7水平TD/TS （P=0.031）的CSA/VBA比值差异均有统计学意义。CSM与DCK组倾向于显示较大的CSA/VBA比的屈肌/伸肌和浅肌/深肌。结论：屈肌相对于伸肌、浅表肌相对于深部肌的力量更大，这在CSM合并DCK的发病机制中起作用，提示颈肩部肌肉加强锻炼对CSM合并DCK患者的重要性。

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Imbalance of Muscles Around the Cervical Spine in Patients with Degenerative Cervical Spondylotic Kyphosis and Myelopathy

Background

To measure the muscle strength around the cervical spine; clarify the relationships among muscles, cervical sagittal alignment, and cervical spondylotic myelopathy (CSM); and understand the process underlying loss of cervical lordosis.

Methods

Sex, age, course of illness, and radiological data were obtained for patients with CSM and a control group of healthy individuals. C2–7 Cobb angles were measured in cervical radiographs, and the vertebral body areas (VBAs) and cross-sectional areas (CSAs) of the deep flexors, superficial flexors, deep extensors, and superficial extensors were measured from the C3/4 to C6/7 intervertebral levels in T2-weighted axial magnetic resonance images. The CSA/VBA ratio was compared among CSM patients with and without degenerative cervical kyphosis (DCK) and control group.

Results

Patients with CSM, especially those with DCK, showed an imbalance of muscles around the cervical spine. The CSA/VBA ratios of superficial flexor/superficial extensor at the C3/4 level (P = 0.036), total flexors/total extensors at the C6/7 level (P = 0.006), total deep muscles/total superficial muscles at the C4/5 level (P = 0.004), and total deep muscles/total superficial muscles at the C6/7 level (P = 0.031) differed significantly among the 3 groups. The CSM with DCK group tended to show larger CSA/VBA ratios of flexors/extensors and superficial muscles/deep muscles.

Conclusions

The greater strength of the flexors relative to the extensors and the superficial muscles compared with the deep muscles plays a role in pathogenesis of CSM with DCK, indicating the importance of neck and shoulder muscle-strengthening exercises in patients showing CSM with DCK.

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS