The Observation On Imaging Of Pathological Segments And Adjacent Segments Of Degenerative Cervical Osteoarthrosis

To explore the change of tilt angle of Facet joint, the dics and Facet joint degenerative grading of pathological segments and adjacent segments of degenerative cervical osteoarthrosis on imaging, which is useful for making better plan before operation, evaluating prognosis and observing pathological changes.30 patients with degenerative C5/6 cervical disc hernia,15 patients with trauma～induced C5/6 cervical disc hernia and 30 cases without cervical disc disease were chosen as cervical disc hernia group, trauma group and control group, respectively. And there was no significantly statistical difference among 3 groups on age and sex.Cervical CT,MRI and X-ray images of the objects of 3 groups were collected by modern imaging techniques, such as 64-slice spiral Computed Tomography (CT) 1.5T Mmagnetic Resonance Imaging (MRI), and Digital Radiography (DR). The tilt angle of facet joint of cervical spine (C5/6) and the adjacent segments on X-ray were measured by ordinary ruler, protractor and vernier caliper, the grading of C5/6 and adjacent segment disc degeneration and facet joint degeneration on CT, MRI images were judged by 3 doctors by double-blind method, then the data could be obtained. All data were analyzed by SPSS15.0 statistical package.Measurement data among 3 groups were compared with ANOVA, then LSD test was used to analyse the difference between 2 groups of 3 groups; Numeration data were compared with chi-square test; and correlation was analysed with Spearman rank correlation analysis.(1) ANOVA showed that there were significantly statistical difference among 3 groups on the facet joint angle of C4～C7 cervical vetebrae, LSD test demonstrated that the angle of C4～C7 cervical vetebrae in cervical disc hernia group and the angle of C5, C6 in trauma group were smaller than those in control group, and the angle of C4, C7 in cervical disc hernia group were smaller than those in trauma group either, and there was significantly statistical difference between every two groups.(2) The results of Chi-square test showed that the constituent ratio of grading on C4/5, C5/6, C6/7 cervical disc and facet joint degeneration among 3 groups were statistically different. For every 2 groups:①Cervical disc degeneration:The degenerative extent of C4/5, C5/6, C6/7 cervical disc in cervical disc hernia group were more serious than those in trauma group and control group, and there was significantly statistical difference between every two groups. And there was statistical difference only on the degenerative extent of C5/6 cervical disc between trauma group and control group.②Facet joint degeneration:The degenerative extent of C4/5, C5/6, C6/7 facet joint in cervical disc hernia group were similar with cervical disc degeneration, which were more serious than those in trauma group and control group, and there was significantly statistical difference between every two groups. However, there was no significantly statistical difference on the degenerative extent of C4/5, C5/6, C6/7 facet joint between trauma group and control group.(3) The results of Spearman rank correlation analysis showed that there was the bivariate positive correlation between C5/6 and C4/5, C5/6 and C6/7 in cervical disc hernia group not only on the extent of cervical disc degeneration, but also on the extent of facet joint degeneration (P<0.05); However, there was no correlation between C5/6 and C4/5, C5/6 and C6/7 in trauma group on these two areas. While on the correlation of facet joint angle of C4～C7 and the degenerative extent of cervical disc, facet joint under corresponding cervical vetebrae, there was significantly and statistically negative correlation between them in cervical disc hernia group, respectively(P<0.05); but in trauma group, there was statistically negative correlation only between the facet joint angle of C5 and the degenerative extent of C5/6 cervical disc(P<0.05), and the others were no correlation.1. The level of facet joint angle become smaller, suggesting cervical spine instability, which is a latent factor to facilitate the occurance of cervical vertebra degenerative diseases.2. The degeneration on cervical disc is often companied by spinal osteoartrosis of adjacent cervical segments.3. Facet joint osteoarthritis caused by intervertebral disc degeneration is the result of mechanical imbalance for a long time.4. Facet joint osteoarthritis is not caused by acute injury, but acute injury may be one of its inducements.5. The changes of pathological segments and adjacent segments of cervical vertebra on imaging are the clue for making better plan before operation, evaluating prognosis and observing pathological changes.