Hongwei Wang , Haocheng Xu , Xianghe Wang , Shuo Yang , Fan Zhang , Feizhou Lyu , Xiaosheng Ma , Jianyuan Jiang , Hongli Wang
{"title":"退行性颈椎病、后凸和脊髓病患者颈椎周围肌肉的不平衡。","authors":"Hongwei Wang , Haocheng Xu , Xianghe Wang , Shuo Yang , Fan Zhang , Feizhou Lyu , Xiaosheng Ma , Jianyuan Jiang , Hongli Wang","doi":"10.1016/j.wneu.2024.123605","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>To measure the muscle strength around the cervical spine; clarify the relationships among muscles, cervical sagittal alignment, and cervical spondylotic myelopathy (CSM); and understand the process underlying loss of cervical lordosis.</div></div><div><h3>Methods</h3><div>Sex, age, course of illness, and radiological data were obtained for patients with CSM and a control group of healthy individuals. C2–7 Cobb angles were measured in cervical radiographs, and the vertebral body areas (VBAs) and cross-sectional areas (CSAs) of the deep flexors, superficial flexors, deep extensors, and superficial extensors were measured from the C3/4 to C6/7 intervertebral levels in T2-weighted axial magnetic resonance images. The CSA/VBA ratio was compared among CSM patients with and without degenerative cervical kyphosis (DCK) and control group.</div></div><div><h3>Results</h3><div>Patients with CSM, especially those with DCK, showed an imbalance of muscles around the cervical spine. The CSA/VBA ratios of superficial flexor/superficial extensor at the C3/4 level (<em>P</em> = 0.036), total flexors/total extensors at the C6/7 level (<em>P</em> = 0.006), total deep muscles/total superficial muscles at the C4/5 level (<em>P</em> = 0.004), and total deep muscles/total superficial muscles at the C6/7 level (<em>P</em> = 0.031) differed significantly among the 3 groups. The CSM with DCK group tended to show larger CSA/VBA ratios of flexors/extensors and superficial muscles/deep muscles.</div></div><div><h3>Conclusions</h3><div>The greater strength of the flexors relative to the extensors and the superficial muscles compared with the deep muscles plays a role in pathogenesis of CSM with DCK, indicating the importance of neck and shoulder muscle-strengthening exercises in patients showing CSM with DCK.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123605"},"PeriodicalIF":1.9000,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Imbalance of Muscles Around the Cervical Spine in Patients with Degenerative Cervical Spondylotic Kyphosis and Myelopathy\",\"authors\":\"Hongwei Wang , Haocheng Xu , Xianghe Wang , Shuo Yang , Fan Zhang , Feizhou Lyu , Xiaosheng Ma , Jianyuan Jiang , Hongli Wang\",\"doi\":\"10.1016/j.wneu.2024.123605\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>To measure the muscle strength around the cervical spine; clarify the relationships among muscles, cervical sagittal alignment, and cervical spondylotic myelopathy (CSM); and understand the process underlying loss of cervical lordosis.</div></div><div><h3>Methods</h3><div>Sex, age, course of illness, and radiological data were obtained for patients with CSM and a control group of healthy individuals. C2–7 Cobb angles were measured in cervical radiographs, and the vertebral body areas (VBAs) and cross-sectional areas (CSAs) of the deep flexors, superficial flexors, deep extensors, and superficial extensors were measured from the C3/4 to C6/7 intervertebral levels in T2-weighted axial magnetic resonance images. The CSA/VBA ratio was compared among CSM patients with and without degenerative cervical kyphosis (DCK) and control group.</div></div><div><h3>Results</h3><div>Patients with CSM, especially those with DCK, showed an imbalance of muscles around the cervical spine. The CSA/VBA ratios of superficial flexor/superficial extensor at the C3/4 level (<em>P</em> = 0.036), total flexors/total extensors at the C6/7 level (<em>P</em> = 0.006), total deep muscles/total superficial muscles at the C4/5 level (<em>P</em> = 0.004), and total deep muscles/total superficial muscles at the C6/7 level (<em>P</em> = 0.031) differed significantly among the 3 groups. The CSM with DCK group tended to show larger CSA/VBA ratios of flexors/extensors and superficial muscles/deep muscles.</div></div><div><h3>Conclusions</h3><div>The greater strength of the flexors relative to the extensors and the superficial muscles compared with the deep muscles plays a role in pathogenesis of CSM with DCK, indicating the importance of neck and shoulder muscle-strengthening exercises in patients showing CSM with DCK.</div></div>\",\"PeriodicalId\":23906,\"journal\":{\"name\":\"World neurosurgery\",\"volume\":\"195 \",\"pages\":\"Article 123605\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-02-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1878875024020552\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1878875024020552","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Imbalance of Muscles Around the Cervical Spine in Patients with Degenerative Cervical Spondylotic Kyphosis and Myelopathy
Background
To measure the muscle strength around the cervical spine; clarify the relationships among muscles, cervical sagittal alignment, and cervical spondylotic myelopathy (CSM); and understand the process underlying loss of cervical lordosis.
Methods
Sex, age, course of illness, and radiological data were obtained for patients with CSM and a control group of healthy individuals. C2–7 Cobb angles were measured in cervical radiographs, and the vertebral body areas (VBAs) and cross-sectional areas (CSAs) of the deep flexors, superficial flexors, deep extensors, and superficial extensors were measured from the C3/4 to C6/7 intervertebral levels in T2-weighted axial magnetic resonance images. The CSA/VBA ratio was compared among CSM patients with and without degenerative cervical kyphosis (DCK) and control group.
Results
Patients with CSM, especially those with DCK, showed an imbalance of muscles around the cervical spine. The CSA/VBA ratios of superficial flexor/superficial extensor at the C3/4 level (P = 0.036), total flexors/total extensors at the C6/7 level (P = 0.006), total deep muscles/total superficial muscles at the C4/5 level (P = 0.004), and total deep muscles/total superficial muscles at the C6/7 level (P = 0.031) differed significantly among the 3 groups. The CSM with DCK group tended to show larger CSA/VBA ratios of flexors/extensors and superficial muscles/deep muscles.
Conclusions
The greater strength of the flexors relative to the extensors and the superficial muscles compared with the deep muscles plays a role in pathogenesis of CSM with DCK, indicating the importance of neck and shoulder muscle-strengthening exercises in patients showing CSM with DCK.
期刊介绍：
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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