颈源性头痛致痛因素的临床研究

摘要

目的:分析颈源性头痛患者的颈椎曲度、颈椎稳定性及MRI表现等致痛因素.方法:颈源性头痛(CEH)组135例,男性31例,女性104,年龄16.3～69.5岁,平均43.2±19.8岁,应用VAS评分对头痛评估,健康对照组86例;应用Borden法测量颈椎侧片上的曲度;应用椎体角度位移(AD)和水平位移(HD)对颈椎失稳评估.结果:CEH组中颈椎反曲及变直的发生率、C2～3,及C3～4椎体失稳发生率和颈椎后缘骨赘形成发生率均高于对照组(P<0.05);CEH组患者疼痛程度VAS与C2～3和C3～4,即上位颈椎稳定性相关(P<0.05).结论:通过本研究发现,颈椎反曲、变直、C2～3及C～4椎体失稳及颈椎后缘骨赘形成可能是CEH的潜在因素,疼痛越重,上位颈椎失稳越重.%Objective: To explore the algogenic factors of the cervical curvature, the cervical stability and the MRI on cervicogenic headache (CEH).Methods: 135 cases with CEH, including 31 male and 104 female, were admitted to the research group.The age was ranged from 16.3 to 69.5.All patients were asked to quantify the pain level on a VAS form.Borden method was used for the cervical curvature, the angular displacement (AD) and the horizontal displacement (HD) for the cervical stability.The control group included 86 healthy cases.Results: The incidence of cervical recurvation, straight, the C2～3 and C3～4 cervical in stability and the posterior cervical osteophyte were higher in the CEH.There were significant differences on VAS, C2～3 and C3～4 cervical stability between two groups (P ＜0.05 ).Conclusion:Cervical recurvation, straight, the C2 ～3 and C3 ～4 cervical instability, and the posterior cervical osteophyte may be the potential factors of CEH.The more severe the headache is, the more instable C2 ～3 and C3～4.