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寰齿关节退行性变及其与枕颈痛的关系 |
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李义凯1 钟世镇1
摘要 目的：确定寰齿关节退行性改变与枕颈痛的关系。方法：随机对54例患者的寰齿关节进行CT扫描评价，分析退变程度与枕颈痛之间的关系。并观察60例寰椎骨性标本寰齿关节面的增生情况。结果：枕颈痛与寰齿关节退变的程度密切相关（P＜0.05），年龄大于40岁者枕颈痛的发生率随之增加。结论：相当一部分中老年枕颈痛与其寰齿关节退变有关。
关键词 骨性关节炎；枕颈痛；寰齿关节；退行性变
Relationship between atlanto-odontoid degeneration and cervico-occipital pain/LI Yikai, ZHONG Shizhen//Chinese Journal of Rehabilitation Medicine,1998,13(5):206～208
Abstract Objective: To determine the relationship between atlanto-odontoid degeneration and cervico-occipital pain. Method: The prensences of the atlanto-odontoid by CT were assessed in 54 consecutive unselected patients, who undergoing CT of the brain or cervical spine for a verity of indications, and the hyperosteogeny of articular surface of articulatio atlanto-dentalis ventralis was evaluated in 60 dry atlases. Result: The presence of atlanto-odontoid osteoarthritis seen on CT was associated with occurrence of the pain, and the occurrence of the cervico-occipital pain was significantly related to the grade of osteoarthritis. The occurrence of neck pain markedly increased from grade 0 to gradeⅠand gradeⅡ in the patients who were elder than 40 years. Conclusion: There were some relations between atlanto-odontoid degeneration and cervico-occipital pain in senile patients.
Author′s address Institute of Clinical Anatomy, the First Military Medical University, Guangzhou, 510515
Key words Osteoarthritis;Cervico-occipital pain;Atlanto-odontoid joint; Degeneration;
颈枕痛是常见的临床症状〔1〕 ，常将其列入颈型颈椎病，治疗多采用康复疗法,如理疗和推拿等。而实际上其病因非常复杂，现已知的有上颈段先天异常、创伤、劳损、肿瘤、类风湿性关节炎和上颈段的骨性关节炎等〔2～4〕 。目前，临床研究重点在椎间盘、Luscka关节、小关节、肌筋膜及退行性变所累及的周围组织上。而对退行性变发生率较高的寰齿关节却很少提及，实际上寰齿关节的退行性变在枕颈痛的发生中起着重要的作用〔5〕。本研究应用CT随机对门诊病人寰齿关节部扫描，并观察骨性标本寰齿关节退行性变的发生率，以分析寰齿关节骨关节炎在颈枕痛中的可能作用。
1 材料和方法
从1995年12月至1996年12月，南方医院门诊病人。记录患者的年龄和性别，排除有颈部创伤史、偏头痛病史及类风湿性关节炎病史的患者，共扫描了54例门诊患者。其中29例男性，25例女性，年龄在26岁～84岁，平均年龄为62岁。其中，脑血管疾病26例、颈型颈椎病18例（神经根型颈椎病不在本研究范围）、其它10例。所有患者均无颅内实质性病变。对其寰齿[1] [2] 下一页
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