摘要
目的:探讨脊髓型颈椎病椎管形态学改变和黄韧带中Ⅰ型/Ⅱ型胶原含量比的相关性。方法:收集颈椎病患者(A组)黄韧带标本84块;颈椎外伤患者(B组)黄韧带标本30块;颈椎病患者中椎间不稳节段(C组)的黄韧带标本为22块;椎间稳定节段(D组)的黄韧带标本为62块。利用CT测量A组和B组的椎管及硬膜囊横截面积,CTM测量A组俯卧过伸位脊髓横截面积;盐析法测定各标本中Ⅰ型/Ⅱ型胶原含量比;将其与椎管、硬膜囊及脊髓的横截面积进行相关性分析。结果:A组黄韧带中Ⅰ型/Ⅱ型胶原含量比、硬膜囊横截面积与B组相比,有显著性差异(P<0.05);C组中Ⅰ型/Ⅱ型胶原含量比值较D组显著增加,而脊髓横截面积及脊髓/椎管横截面积之比则显著下降(P<0.05)。A组黄韧带中Ⅰ型/Ⅱ型胶原含量比与仰卧过伸位的脊髓横截面积/椎管横截面积之间存在显著相关性(P<0.05)。结论:脊髓型颈椎病患者硬膜囊和脊髓横截面积的下降可能与Ⅱ型胶原过度增加、黄韧带代偿性肥厚有关,同时椎间节段不稳可加速黄韧带的这种退变。
Objective：To study the relationship between cervical canal morphological change and the ratio of type Ⅰ/type Ⅱ collagen in degenerative cervical ligamentum flavum.Method：84 samples of ligamentum flavum sample due to cervical spondylotic myelopathy were collected as group A,and 30 samples of cervical vertebral trauma as group B.In group A,22 cases with unstable segment were regarded as group C,62 cases with stable segments were regarded as group D.Morphological change and cross-sectional area of spinal canal of each group were determined by CT scan,cross-sectional area of cervical spinal cord in prone position with neck extended in group A was obtained through CTM （CT-myelography）.The ratio of type Ⅰ/type Ⅱ collagen was determined by salting out analysis.The relationship between the ratio of type Ⅰ/type Ⅱ collagen and factors such as the cross-sectional area of spinal canal and spinal cord was explored.Result：The ratio of type Ⅰ/type Ⅱ collagen and cross-sectional area of dural sac in group A had a remarkable increase compared with group B.Increase of ratio of type Ⅰ/type Ⅱ collagen and the decline of cross-sectional area of dural sac were more remarkable in group C than in group D.There were linear positive relationship between the ratio of type Ⅰ/ type Ⅱ collagen and cross-sectional area of spinal cord/spinal canal （P〈0.05）.Conclusion：For patients with cervical spondylotic myelopathy,the decline of cross-sectional area of dural sac and spinal cord may be associated with the overincreasement of the type Ⅱ collagen and the hypertrophy of ligamentum flavum.Instability of vertebral segment may accelerate the degenerative process.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2007年第2期126-128,共3页
Chinese Journal of Spine and Spinal Cord
关键词
脊髓型颈椎病
椎管形态学
黄韧带
退变
Cervical spondylotic myelopathy
Cervical canal morphology
Ligament flavum
Degenerate
