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中國正常成人頸椎管縱切面前後徑的測量
THE SAGITTAL DIAMETER OF THE CERVICAL SPINAL CANAL IN CHINESE NORMAL ADULTS
摘要
許多在頸部神經系統的疾病，與頸椎管的大小是息息相關的，太寬或太窄，都有其特殊的臨床意義。諸如，髓內腫瘍、脊髓空洞病，會使椎管變大。或者，神經弓推板發育不全會導致頸椎管狹窄，有時，只要稍許的椎關節病變，便引起明顯的頸脊髓病變及神經根症狀。因此，由頸椎管的大小，可推測患者可能的病變或預測病人將有的神經症狀。我們做這個研究的目的，就是要測量國人正常成人頸椎管縱切面前後徑的平均值及其正常範圍。藉以使臨床診斷上有個準則可循。我們搜集了自民國六十七年十月至民國六十九年一月間在台大醫院做健康檢查的1023個成年人，其中包括572個男性，及451個女性；年齡從十八歲到八十七歲。他們每個人都做了一般側面和正面的頸脊柱X光攝影檢査，以資測量。爲了知道頸脊柱在X光片上側面投影的放大率，在照像時，放置一塊長2 cm，寬1 cm的鉛片在受檢者頸背正中央處。因此，可測知每一個例的頸脊柱放大率，而求得真正的頸椎管縱切面前徑的寬度。測量結果爲男性頸脊管之前後徑C-1爲19.1 mm（平均值）±1.9 mm（標準差），C-2爲16.9 mm±1.6 mm，C-3爲14.5 mm±1.2 mm，C-4爲13.9 mm±1.3 mm，C-5爲14.0 mm±1.3 mm，C-6爲14.1 mm±1.2 mm，C-7爲14.2 mm±1.3 mm;女性頸椎管之前後徑C-1爲18.0 mm±1.8 nnn，C-2爲15.9 mm±1.5 mm，-C-3爲13.3 mm±1.3 mm，C-4爲13.4 mm±1.3 mm，C-5爲13.4mm±1.3 mm，C-6爲13.5 mm±1.2 mm，C-7爲13，6mm±1.2 mm。比較男女之間，在相對應頸椎管的前後徑大小。得知在C-1、C-2處，男的比女的大1 mm左右，在C-3至C-7處，男的比女的大0.5 mm左右。在這個測量研究裏，男女間頸椎管前後徑大小的差異是有意義的。
並列摘要
1023 adults of the physical examinations, including 572 men and 451 women, pertor-med at NTUH from Oct. 1978 to Jan. 1980 have been survyed. The routine anteropo-sterior and lateral radiographs were taken among these cases. The age range of the examiners is from 18 to 87 years old. To measure the sagittal diameter of the cervical spinal canal and detect the magnifying factor of the cervical spoine on the lateral radiograph, a piece of the standard lead is put at the back of the neck on the midline during taking radiograph. The actual sagittal diame ter of bony canal of the cervical spine is calculated. In the males, the mean sagittal diameter at the level of C-1 is 19.1mm ± 1.9mm (standard deviation), C-2 is 16.9mm 1.6mm, C-3 is 14.5mim ± 1.2mm, C-4 is 13.9mm ± 1.3mm, C-5 is 14.0mm ± 1.3mm, C-6 is 14.1mm ± 1.2mm, C-7 is 14.2mm ± 1.3mm. In the females, C-1 is 18.0mm ± 1.8mm, C-2 is 159mm ± 1.5mm, C-3 is 13.8mm ± 1.3mm, C-4 is 13.4mm ± 1.3mm, C-5 is 13.4mm ± 1.3mm, C-6 is 13.5mm ± 1.2mm, C-7 is 13.6mm ± 1.2mm. The sagittal diameters of the cervical spinal canal for a corresponding vertebra between the male and female disclose that the male's is wider than the female's with a diameter of 1.0mm at the C-1 and C-2, and 0.5-0.8mm at the C-3 to C-7. The differences of the sagittal diameters of the bony canal at the level from C-1 to C-7 between the males and the females are significant.