<div>大骨节病对下颈椎椎间隙高度及形态的影响</div>

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目的通过测量中老年大骨节病(Kashin-Beck disease，KBD)患者下颈椎椎间隙高度，观察椎间隙的影像学形态，明确大骨节病对下颈椎椎间隙高度及形态的影响。方法纳入2019年8月至2019年12月在甘肃宁县第二人民医院检查的KBD患者(KBD组)92例，其中男38例，女54例；年龄47~70岁，平均(58.89±7.67)岁，以及非KBD人群(对照组)98例，其中男42例，女56例；年龄49~69岁，平均(58.35±7.38)岁。两组人群行颈椎侧位X线片检查，观察下颈椎间隙影像学表现；测量两组C_2～7椎间隙前缘、中间及后缘高度，并进行统计学分析。结果结果显示KBD组男、女C_4～7椎间隙中间高度均低于C_2～4，差异有统计学意义(P＜0.05)。KBD组男、女C_2～4椎间隙中间高度低于对照组，但差异无统计学意义(P＞0.05)，而C_4～7椎间隙中间高度均低于对照组，差异有统计学意义(P＜0.05)。KBD组男、女患者C_2～4椎间隙中间高度相比，差异有统计学意义(P＜0.05)，而两性别C_4～7椎间隙中间高度相比，差异无统计学意义(P＞0.05)。根据椎间隙的高度及形态X线表现，可分为间隙正常型27例(29.35%)、增宽型11例(11.96%)、狭窄型42例(45.65%)及椭圆型12例(13.04%)。其特征性改变为部分椎体终板上下面凹陷、凹凸不平、硬化。结论 KBD并不影响颈椎间盘发育，但KBD患者更倾向于发生椎间盘退变，高度丢失。本研究初步证实KBD与颈椎椎间盘退变发生可能具有一定相关性。

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	吴学元
	易智
	马宏伟
	凌鸣
	靳占奎
	孙正明

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大骨节病, 椎间高度, 终板, 下颈椎, 影像学形态

Abstract：Objective To measure the height of cervical intervertebral space and observe the imaging morphology in elderly patients with Kashin-Beck disease(KBD)to clarify the influence of KBD on the lower cervical vertebrae.Methods From Aug 2019 to Dec 2019，a total of 92 patients with KBD (38 men and 54 women)with an average age of (58.89±7.67)years (range：47~70 years)and 98 healthy subjects (42 men and 56 women)with an average age of (58.35±7.38)years (range：49~69 years)were enrolled and examed at the Second People's Hospital of Ning Xian.The KBD patients (KBD group)and the healthy subjects (control group)were taken with lateral cervical radiographs to observe the imaging manifestations of the lower cervical intervertebral space.The anterior，middle and posterior heights of the intervertebral space from C_2～7in neutral position were measured and statistical analysis was performed.Results The results of this study showed that the middle heights of C_4～7in male and female in KBD group were lower than that of C_2～4，with significant statistical difference (P＜0.05).The middle heights of C_2～4 in both male and female in KBD group were lower than those in the control group，but with no statistical significance (P＞0.05).The middle heights of C_4～7 in both male and female in KBD group were lower than those of control group (P＜0.05).There were statistically significant differences in the middle height of C_2～4 between male and female patients in KBD group (P＜0.05)，and there was no significant difference in the middle heights of C_4～7 between the two genders (P＞0.05).The X-ray examination showed that imaging morphologies of lower cervical intervertebral space were divided into normal intervertebral height in 27 cases (29.35%)，widened height in 11 cases (11.96%)，narrow height in 42 cases (45.65%) and elliptical space in 12 cases (13.04%) based on the height and shape of the intervertebral space.The characteristic changes of endplate were depression，uneven or sclerosis.Conclusion The KBD does not affect the development of cervical intervertebral disc，while，the patients with KBD are prone to the occurrence of cervical disc degeneration and height loss.This study primarily confirmed that KBD and cervical disc degeneration may have a certain correlation.

Key words： Kashin-Beck disease intervertebral heights endplate lower cervical vertebrae radiographic morphology

基金资助:陕西省自然科学基础研究计划项目(2019JM-517)
陕西省人民医院科技发展孵化基金(2019YXQ-10)
陕西省重点研发计划项目(2018ZDXM-SF-054)

作者简介: 吴学元(1981－ )，男，副主任医师，陕西省人民医院骨科，wuxueyuan81@163.com

引用本文:

吴学元，易智，马宏伟，凌鸣，靳占奎，孙正明.

大骨节病对下颈椎椎间隙高度及形态的影响

[J]. 实用骨科杂志, 2022, 28(8): 673-678.
Wu Xueyuan，Yi Zhi，Ma Hongwei，Ling Ming，Jin Zhankui，Sun Zhengming. Effect of Kashin-Beck Disease on the Height and Morphology of Lower Cervical Intervertebral Space. sygkzz, 2022, 28(8): 673-678.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2022/V28/I8/673

［1］Zhang Y，Wei X，Cao C，et al.Identifying discriminative features for diagnosis of Kashin-Beck disease among adolescents［J］.BMC Musculoskelet Disord，2021，22(1)：801.
［2］郭雄.WS/T 79-2011《大骨节病治疗效果判定》标准解读［J］.中国卫生标准管理，2017，8(24)：1-3.
［3］Wang K，Yu J，Liu H，et al.Endemic Kashin-Beck disease：A food-sourced osteoarthropathy［J］.Semin Arthritis Rheum，2020，50(2)：366-372.
［4］Wu X，Ling M，Chang Y，et al.Accidental or linked：separated odontoid process fused to the enlarged anterior arch of the atlas associated with atlantoaxial subluxation in a KashinBeck disease patient［J］.Eur Spine J，2017，26(Suppl 1)：85-89.
［5］胡柳，吕永曼，林阳.无症状成人颈椎间隙高度随年龄变化的相关研究［J］.生物骨科材料与临床研究，2020，17(5)：21-24.
［6］Patil P，Niedernhofer LJ，Robbins PD，et al.Cellular senescence in intervertebral disc aging and degeneration［J］.Curr Mol Biol Rep，2018，4(4)：180-190.
［7］van Eerd M，Patijn J，Loeffen D，et al.The diagnostic value of an X-ray-based scoring system for degeneration of the cervical spine：A reproducibility and validation study［J］.Pain Pract，2021，21(7)：766-777.
［8］Kolstad F，Myhr G，Kvistad K A，et al.Degeneration and height of cervical discs classified from MRI compared with precise height measurements from radiographs［J］.Eur J Radiol，2005，55(3)：415-420.
［9］Choi S H，Lee H，Cho JH，et al.Radiological parameters of undegenerated cervical vertebral segments in a korean population［J］.Clin Orthop Surg，2017，9(1)：63-70.
［10］Tao Y，Galbusera F，Niemeyer F，et al.Radiographic cervical spine degenerative findings：A study on a large population from age 18 to 97 years［J］.Eur Spine J，2021，30(2)：431-443.
［11］姜锦鹏，顾洪生，刘伟强，等.正常成人颈椎间盘相关参数测量及意义［J］.中国临床解剖学杂志，2013，31(1)：32-36.
［12］张亘瑷，江建明，金大地.人工颈椎间盘置换术的解剖学参数测量［J］.中国临床解剖学杂志，2006，24(3)：283-285.
［13］王顺民，徐锡明，杨勇，等.颈椎间盘解剖高度、自然高度和病理高度X线片测量及临床意义［J］.第二军医大学学报，2018，39(6)：667-670.
［14］中共中央地方病防治领导小组办公室.永寿大骨节病科学考察文集［M］.北京：人民卫生出版社，1984：434.
［15］Ariga K，Miyamoto S，Nakase T，et al.The relationship between apoptosis of endplate chondrocytes and aging and degeneration of the intervertebral disc［J］.Spine (Phila Pa 1976)，2001，26(22)：2414-2420.
［16］Xu HM，Hu F，Wang XY，et al.Relationship Between Apoptosis of Endplate Microvasculature and Degeneration of the Intervertebral Disk［J］.World Neurosurg，2019(125)：e392-e397.
［17］Kolstad F，Myhr G，Kvistad K A，et al.Degeneration and height of cervical discs classified from MRI compared with precise height measurements from radiographs［J］.Eur J Radiol，2005，55(3)：415-420.