中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (21): 4486-4491.doi: 10.12307/2025.102

• 数字化骨科Digital orthopedics • 上一篇    下一篇

13-18岁青少年颈椎关节突关节发育特征的数字化三维形态分析

李贵花1，和雨洁2，史  君3，李  琨2，4，张少杰2，4，刘  路2，李志军2，4，王  星2，4   

  1. 1内蒙古自治区监狱管理局第一医院，内蒙古自治区呼和浩特市   010000；内蒙古医科大学基础医学院，2解剖学教研室，3生理学教研室，4数字医学中心，内蒙古自治区呼和浩特市    010110
  • 收稿日期:2023-09-05 接受日期:2023-11-30 出版日期:2025-07-28 发布日期:2024-12-05
  • 通讯作者: 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，数字医学中心，内蒙古自治区呼和浩特市 010110 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，数字医学中心，内蒙古自治区呼和浩特市 010110
  • 作者简介:李贵花，女，1986年生，内蒙古自治区呼和浩特市人，汉族，2018年内蒙古医科大学毕业，硕士，主治医师，主要从事脊柱与脊髓的数字化研究。 并列第一作者：和雨洁，女，1988年生，内蒙古自治区呼和浩特市人，汉族，讲师，主要从事影像解剖学研究。
  • 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(YKD2021QN011)，项目负责人：和雨洁；内蒙古医科大学青年基金项目(YKD2020QNCX055)，项目负责人：李琨

Digital three-dimensional morphological analysis of developmental characteristics of cervical facet joints in adolescents aged 13-18 years

Li Guihua1, He Yujie2, Shi Jun3, Li Kun2, 4, Zhang Shaojie2, 4, Liu Lu2, Li Zhijun2, 4, Wang Xing2, 4   

  1. 1First Hospital of Prison Administration Bureau of Inner Mongolia Autonomous Region, Hohhot 010000, Inner Mongolia Autonomous Region, China; 2Department of Anatomy, 3Department of Physiology, 4Digital Medicine Center, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China
  • Received:2023-09-05 Accepted:2023-11-30 Online:2025-07-28 Published:2024-12-05
  • Contact: Li Zhijun, Professor, Doctoral supervisor, Department of Anatomy, and Digital Medicine Center, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China Wang Xing, MD, Associate professor, Department of Anatomy, and Digital Medicine Center, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China
  • About author:Li Guihua, MS, Attending physician, First Hospital of Prison Administration Bureau of Inner Mongolia Autonomous Region, Hohhot 010000, Inner Mongolia Autonomous Region, China He Yujie, Lecturer, Department of Anatomy, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China Li Guihua and He Yujie contributed equally to this article.
  • 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); Youth Science and Technology Talents Support Program of Higher Education Institutions of Inner Mongolia Autonomous Region, No. NJYT22009 (to WX); Science and Technology Plan Project of Inner Mongolia Autonomous Region, No. 2019GG158 (to WX); Key Research Project of Inner Mongolia Medical University, No. YKD2021ZD011 (to WX); Health Commission Medical Health Technology Project of Inner Mongolia Autonomous Region, 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. YKD2021QN011 (to HYJ); Youth Fund Project of Inner Mongolia Medical University, No. YKD2020QNCX055 (to LK) 

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摘要：

文题释义：

青春期：女孩从11-12岁开始到17-18岁、男孩从13-14开始到18-20岁为青春期，是人一生的第二个生长高峰，以身高的快速增长为特点。
颈椎关节突关节：C2-3-C6-7间关节突关节为滑膜关节，由上位颈椎的下关节突与下位颈椎的上关节突构成，关节囊附着于关节软骨的边缘，是椎管后壁构成的一部分，前方与椎动脉相邻，其活动范围较大，创伤时易引起脱位或半脱位。

摘要
背景：颈椎关节突关节作为颈椎后柱的重要解剖结构，在颈部活动、应力传导以及维持颈椎稳定性中发挥重要的作用。近年来通过解剖学和生物力学研究表明，颈椎关节突关节不对称可引起关节突关节的退变，颈椎关节突关节的退变可能是引起青年人颈椎退变的主要原因。现有研究多集中在成人，国内对于学龄前儿童、学龄期儿童也有报道，而对于青少年颈椎小关节形态相关参数鲜有报道。
目的：通过三维重建青少年颈椎关节突关节，测量其相关形态参数，并与儿童和成年人进行比较分析，探讨颈椎小关节形态发育的增龄变化规律，为临床颈椎小关节源性颈椎病的诊治和预防提供理论依据。
方法：选择13-18岁青少年62例，行颈椎螺旋CT扫描后三维重建，要求无骨质破坏、肿瘤、畸形、骨折等，椎骨形态结构未发生改变，既往无脊柱相关手术，监护人对试验方案知情同意。按年龄分组，A组年龄为13-14岁，B组年龄为15-16岁，C组年龄为17-18岁。对各组青少年进行C2-C7关节突关节相关形态测量及统计分析。
结果与结论：①3组关节突关节面高和关节面宽在随椎序的变化中，分别呈递减和递增趋势，下关节突关节面的高和宽均大于上关节面的相应指标；②关节突关节内高在3组年龄中，最小值均位于C5，且与年龄呈正相关变化；③关节突关节面间隙在3组中，A组C4-5、B组C3-4和C组C4-5明显大于各组其余间隙；A、B组除C4-5外，其余无显著性差异；C组除C2-3其余椎序间关节面间隙均明显大于A、B组；④提示颈椎关节突关节面的形态随椎序的增加，逐渐由圆形过渡到椭圆形；在组间比较中，关节面高较关节面宽受年龄影响明显；各节段下关节面的面积均大于上关节面的面积，仅在C4-5和C5-6形态和面积有显著性差异；加之关节突关节内高最小值均位于C5，关节突关节面间隙明显增宽处也主要位于C3-4和C4-5，因此颈椎失稳多发生于中位节段。


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: 青少年, 颈椎, 关节突关节, 数字化形态, 三维重建

Abstract: BACKGROUND: The cervical facet joint, as an important anatomical structure of the posterior column of the cervical spine, plays an important role in neck activity, stress transmission, and maintaining cervical stability. In recent years, anatomical and biomechanical studies have shown that asymmetry of cervical facet joints can cause degeneration of facet joints, which may be the main cause of cervical spine degeneration in young people. Existing research is mostly focused on adults, and there are also reports on preschool and school-age children in China, while there are few reports on the morphological parameters of cervical facet joints in adolescents.
OBJECTIVE: Through three-dimensional reconstruction of the cervical facet joints in adolescents, measuring their relevant morphological parameters, and comparing them with those in children and adults, we explored the age-related changes in the morphological development of cervical facet joints, providing a theoretical basis for the diagnosis, treatment, and prevention of cervical spondylosis arising from cervical facet joints.
METHODS: A total of 62 adolescents aged 13-18 years were selected to undergo spiral CT scan of cervical vertebrae and 3D reconstruction, requiring no bone destruction, tumor, deformity, or fracture, no changes in vertebrae morphology and structure, no previous spinal operations. The guardian’s informed consent to the experimental protocol was obtained. By age group, group A was 13-14 years old; group B was 15-16 years old; group C was 17-18 years old. The correlation morphometry and statistical analysis of C2-C7 facet joints were performed in adolescents of each group.
RESULTS AND CONCLUSION: (1) In three groups of subjects, the facet joint surface heights and widths displayed decreasing and increasing trends in relation to the change of vertebra order. The facet joint surfaces on the inferior surface showed larger height and width compared to the corresponding indicators on the superior surface. (2) The intra-articular height of the articular process was lowest in C5 among the three groups of ages, and it showed a positive correlation with age. (3) Among the three groups, the gaps between the articular surfaces of the joints in C4-5 of group A, C3-4 of group B, and C4-5 of group C were significantly larger than the rest of the gaps in each group. Except for C4-5, there were no significant differences between the two groups. Except for C2-3, 
the remaining gaps between the vertebrae in group C were significantly larger than those in the two groups. (4) It is indicated that the morphology of the cervical facet joint surface gradually transitions from circular to elliptical as the vertebral order increases. In inter-group comparison, facet joint surface height is significantly affected by age compared to facet joint surface width. The area of the lower facet joint surface of each segment is greater than that of the upper facet joint surface, with only significant differences in the shape and area of C4-5 and C5-6. In addition, the minimum height of the facet joint is located at C5, and the significantly widened gap between the facet joint surfaces is mainly located at C3-4 and C4-5. Therefore, cervical instability often occurs at the mid-level. 

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

Key words: adolescents, cervical vertebrae, facet joint, digital morphology, three-dimensional reconstruction

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