CAJ | 학술논문

目的探讨颈椎过伸性损伤的退变性因素、损伤节段的分布及其原因.方法温州医学院附属东阳医院89例颈椎过伸性损伤患者进行回顾性分析,统计颈椎退行性病变、T2WI相脊髓高信号的位置及颜面部外伤的位置.结果间盘突出58例,居首位;其后依次为后纵韧带骨化(8例)、发育性椎管狭窄(7例)及椎间盘突出+黄韧带肥厚(6例).单节段T2WI相脊髓高信号在椎间盘水平:C2～3者4例,额部外伤1例;C3～4者12例,额部外伤10例,颧部外伤1例;CA～5者12例,额部外伤5例,额部+颧部外伤1例,额部+下颌部外伤1例;C5～6者11例,额部外伤3例,颧部外伤3例,下颌部外伤2例.单节段脊髓高信号位置不在椎间盘水平4例,脊髓高信号在两个不连续节段10例,脊髓高信号超过2个节段2例,脊髓高信号超过3个节段6例.结论椎间盘突出是颈椎过伸性损伤患者最多见的退变性因素,T2WI相脊髓高信号的水平与额面部撞击的部位相关,拐点的剪切力(inflection point shear force)合并(或)颈椎过伸的前后挤压力是颈椎过伸性损伤的机制.
목적 탐토경추과신성손상적퇴변성인소、손상절단적분포급기원인.방법 온주의학원부속동양의원89례경추과신성손상환자진행회고성분석,통계경추퇴행성병변、T2WI상척수고신호적위치급안면부외상적위치.결과 간반돌출58례,거수위;기후의차위후종인대골화(8례)、발육성추관협착(7례)급추간반돌출+황인대비후(6례).단절단T2WI상척수고신호재추간반수평:C2～3자4례,액부외상1례;C3～4자12례,액부외상10례,권부외상1례;CA～5자12례,액부외상5례,액부+권부외상1례,액부+하합부외상1례;C5～6자11례,액부외상3례,권부외상3례,하합부외상2례.단절단척수고신호위치불재추간반수평4례,척수고신호재량개불련속절단10례,척수고신호초과2개절단2례,척수고신호초과3개절단6례.결론 추간반돌출시경추과신성손상환자최다견적퇴변성인소,T2WI상척수고신호적수평여액면부당격적부위상관,괴점적전절력(inflection point shear force)합병(혹)경추과신적전후제압력시경추과신성손상적궤제.
Objective To discuss the degenerative factors, the spinal segment distribution, and the mechanism in hyperextension injury of cervical spine. Method Eighty-nine patients with hyperextension injury of cervical spine were retrospectively analyzed by observing the degenerativelesion, the spinal cord segment with high signal in T2WI, and the location of facial trauma. Results Fifty-eight cases showed the disc hemiation which was the most common lesion, followed by 8 cases showing the calcification of the posterior longitudinal ligament. Besides, 7 cases presented the developmental stenosis of spinal canal, and also, 6 cases showed disc hemiation combined with the yellow ligament hypertrophy. The intervertebral level of the spinal cord with high signal in T2WI were distributed as follows:4 cases were at C2/3, of which onesuffered the forehead trauma; 12 cases were at C3/ 4, of which 10 had the forehead trauma, and one had the zygomatic trauma; 12 cases were at C4/5, of which 5 had the forehead trauma, one had both the zygomatic and the forehead trauma, and one had both the forehead and with the lower jaw trauma; 11 cases were at CS/6,of which 3 had the forehead trauma, 3 had the zygomatic trauma, and 2 had the lower jaw trauma. The location of the spinal cord with single high signal in T2WI did not correspond with the intervertebral disc level in 4 cases. For 10 cases the high signal in T2WI was found at two discontinuous segments. For 2 cases the 1 high signal in T2WI was found at over two segments. For 6 cases the high signal in T2WI was found at over three segments. Conclusions Disc hemiation is the most common underlyding factor in cervical hyperextension injury. The spinal level with high signal in T2WI was correlative to the impacted facial site. The shear force at the inflection point with or without the anterior-posterior compression force accounted for the cervical hyperextension injury.