中国组织工程研究

中国组织工程研究 ›› 2024, Vol. 28 ›› Issue (36): 5766-5772.doi: 10.12307/2024.680

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

颈椎钩突相关夹角增龄变化的特征与意义

张德洲1，王超群2，史  君3，李  琨4，5，张少杰4，5，马  渊5，侯二飞4，赵丹阳5，郝韵腾1，王思敏1，李筱贺4，王海燕4，李志军4，5，王  星4，5   

  1. 1内蒙古医科大学研究生院，内蒙古自治区呼和浩特市   010110；2内蒙古医科大学附属医院影像科，内蒙古自治区呼和浩特市  010050；内蒙古医科大学基础医学院，3生理学教研室，4解剖学教研室，内蒙古自治区呼和浩特市   010110；5内蒙古医科大学基础医学院数字医学中心，内蒙古自治区呼和浩特市   010059
  • 收稿日期:2023-06-27 接受日期:2023-09-18 出版日期:2024-12-28 发布日期:2024-02-27
  • 通讯作者: 王星，博士，副教授，内蒙古医科大学基础医学院解剖学教研室，内蒙古自治区呼和浩特市 010110；内蒙古医科大学基础医学院数字医学中心，内蒙古自治区呼和浩特市 010059 李志军，教授，博士生导师，内蒙古医科大学基础医学院解剖学教研室，内蒙古自治区呼和浩特市 010110；内蒙古医科大学基础医学院数字医学中心，内蒙古自治区呼和浩特市 010059
  • 作者简介:张德洲，男，1998年生，贵州省铜仁市人，土家族，内蒙古医科大学在读硕士，主要从事脊柱与脊髓的数字化研究。 王超群，男，1988年生，内蒙古自治区五原县人，汉族，主要从事影像诊断方面的研究。
  • 基金资助:
    国家自然科学基金资助项目(81860383)，项目负责人：李志军；内蒙古自治区自然科学基金资助项目(2020LH08021)，项目负责人：李志军；国家自然科学基金资助项目(81860382)，项目负责人：王星；内蒙古自治区自然科学基金资助项目(2020MS03061)，项目负责人：王星；内蒙古自治区高等学校青年科技英才支持计划资助(NJYT22009)，项目负责人：王星；内蒙古自治区科技计划项目(2019GG158)，项目负责人：王星；内蒙古医科大学科研重点项目(YKD2021ZD011)，项目负责人：王星；内蒙古自治区卫生健康委医疗卫生科技计划项目(202201217)，项目负责人：王星；内蒙古自治区自然科学基金资助项目(2019MS08017)，项目负责人：张少杰，内蒙古医科大学青年基金项目(YKD2020QNCX055)，项目负责人：李琨

Characteristics and significance of age-related changes in cervical uncinate process-related angle

Zhang Dezhou1, Wang Chaoqun2, Shi Jun3, Li Kun4, 5, Zhang Shaojie4, 5, Ma Yuan5, Hou Erfei4, Zhao Danyang5, Hao Yunteng1, Wang Simin1, Li Xiaohe4, Wang Haiyan4, Li Zhijun4, 5, Wang Xing4, 5   

  1. 1Graduate School of Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China; 2Department of Imaging, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China; 3Department of Physiology, 4Department of Anatomy, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China; 5Center for Digital Medicine, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010059, Inner Mongolia Autonomous Region, China
  • Received:2023-06-27 Accepted:2023-09-18 Online:2024-12-28 Published:2024-02-27
  • Contact: Wang Xing, PhD, Associate professor, Department of Anatomy, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China; Center for Digital Medicine, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010059, Inner Mongolia Autonomous Region, China Li Zhijun, Professor, PhD supervisor, Department of Anatomy, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China; Center for Digital Medicine, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010059, Inner Mongolia Autonomous Region, China
  • About author:Zhang Dezhou, Master candidate, Graduate School of Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China Wang Chaoqun, Department of Imaging, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China
  • Supported by:
    National Natural Science Foundation of China, No. 81860383 (to LZJ); Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2020LH08021 (to LZJ); National Natural Science Foundation of China, No. 81860382 (to WX); Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2020MS03061 (to WX); Support Program for Young Scientists and Technologists in Higher Education Institutions of Inner Mongolia Autonomous Region, No. NJYT22009 (to WX); Science and Technology Program of Inner Mongolia Autonomous Region, No. 2019GG158 (to WX); Key Project of Scientific Research of Inner Mongolia Medical University, No. YKD2021ZD011 (to WX); Medical and Health Science and Technology Program of Inner Mongolia Autonomous Region Health and Health Commission, No. 202201217 (to WX); Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2019MS08017 (to ZSJ); Youth Fund Project of Inner Mongolia Medical University, No. YKD2020QNCX055 (to LK)

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摘要：


文题释义：

钩椎关节：又称Luschka关节(Luschka joint)，是由颈椎椎体上面侧方的骨性突起——钩突与相邻上位椎体下面侧方的斜坡关节面构成，具有限制椎体间侧方移位的作用。是由德国解剖学家Von Luschka于1858年首次观察发现并提出，后学术界以其名字命名了钩椎关节。
钩突：位于椎体上面后外侧呈矢状位的嵴样隆起，与椎间孔、横突孔及椎间盘紧密相邻。该结构的增生、骨折等病变往往会压迫神经根、椎动脉、交感神经等结构，导致相应颈椎病症状的发生，因此针对该关节的研究也比较广泛。


背景：钩椎关节作为颈椎所特有的结构，其发生、发展和发育直接影响着颈椎的稳定性和活动度，也与颈椎病的发病密切相关，深入了解钩椎关节的发育特点对颈椎病的发病类型、诊断与治疗有着重要意义。 

目的：利用影像学和三维重建技术对不同年龄段的颈椎钩突相关夹角进行大样本测量和观察，旨在揭示其随年龄和椎骨增长变化的特点，以及与颈椎稳定性之间的关系。
方法：采用回顾性设计，将收集到的符合研究要求的1 447例完整颈椎节段CT影像学资料的原始数据以DICOM格式导入Mimics 21.0软件进行后处理，并进行钩突夹角、钩突矢状位角测量，按照性别、年龄、侧别分组。

结果与结论：①钩突夹角随椎序的增加呈V字形增长，其最低峰值位于C5处；总体随年龄的增长呈尖峰状，其峰值多介于30-39岁年龄范围内；②钩突矢状位角随椎序的增加呈鱼钩样增长、总体随年龄的递增也呈尖峰状，其峰值多介于20-29岁年龄范围内；钩突夹角与钩突矢状位角在侧别和性别间仅部分存在显著性差异(P < 0.05)；③提示钩突夹角随椎序递增呈V字形增长；钩突矢状位角随椎序递增鱼钩样增长，而2个夹角随年龄的增长总体呈尖峰状，钩突夹角在131°左右，可能与颈椎的稳定性密切相关；而钩突矢状位角在14°左右，可能对限制颈椎过度旋转有一定作用。

https://orcid.org/0000-0003-0059-4921 (王星) 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 钩突, 钩突夹角, 钩突矢状位角, 增龄变化, 颈椎稳定性

Abstract: BACKGROUND: As a unique structure of the cervical spine, the occurrence, development and progression of the uncovertebral joint directly affect the stability and range of motion of the cervical spine, and are also closely related to the pathogenesis of cervical spondylosis. A thorough understanding of the developmental characteristics of the uncovertebral joint is of great significance for the pathogenesis, diagnosis, and treatment of cervical spondylosis.
OBJECTIVE: By using imaging and three-dimensional reconstruction technology to measure and observe the cervical uncinate process-related angle in a large sample of different age groups, the aim is to reveal the characteristics of its changes with age and vertebral growth, as well as its relationship with cervical spine stability. 
METHODS: Using a retrospective research design, we collected 1 447 cases of raw CT imaging data that meet the study requirements for complete cervical spine segments. The raw data were imported into Mimics 21.0 software in DICOM format for post-processing and measurement of angle of uncinate process and sagittal angle of uncinate process. The data were grouped based on gender, age, and side.
RESULTS AND CONCLUSION: (1) With the increase of vertebral sequence, the angle of uncinate process increased in a V-shaped shape, and the lowest peak was at C5. The overall population showed a sharp peak with the increase of age, and the peak value mostly occurred in the age range of 30-39 years. (2) The sagittal angle of the uncinate process increased like a fishhook with the increase of the vertebral sequence, and the overall angle of the uncinate process increased with age, and the peak value mostly occurred in the age range of 20-29 years. The uncinate process angle and sagittal angle showed only partial significant differences between sides and genders (P < 0.05). (3) It is concluded that the angle of the uncinate process increased with the increase of vertebral sequence in a V-shaped manner. The sagittal angle of the uncinate process increases like a fish hook with increasing vertebral order, while the two angles generally peak with increasing age. The angle of the uncinate process is about 131°, which may be closely related to the stability of the cervical spine, while the sagittal angle of the uncinate process is about 14°, and its function may play a certain role in limiting the excessive rotation of the cervical spine. 

Key words: uncinate process, uncinate process angle, sagittal angle of uncinate process, changes with aging, cervical spine stability

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