| 任东成,丁金勇,徐继禧,谭成双,刘俊城,李健雄,谢炜星,梁 德.青少年腰椎间盘突出症患者下腰椎关节突关节不对称情况分析[J].中国脊柱脊髓杂志,2019,(5):437-443. |
| 青少年腰椎间盘突出症患者下腰椎关节突关节不对称情况分析 |
| 中文关键词: 腰椎间盘突出症 青少年 关节突关节 不对称 |
| 中文摘要: |
| 【摘要】 目的：测量青少年腰椎间盘突出症（lumbar disc herniation，LDH）患者下腰椎关节突关节角度，观察其关节突关节不对称（facet tropism，FT）情况。方法：选取2012年8月~2018年8月在我院就诊的LDH和腹部疾病患者。LDH组共纳入52例，其中男42例，女10例，年龄为17.9±1.4岁（14~20岁）；L4/5椎间盘突出33例， L5/S1突出18例，L4/5、L5/S1双节段椎间盘突出1例；中央型椎间盘突出24个节段，左侧突出18个节段，右侧突出11个节段。选择腹部CT扫描的层面经过椎间盘且与上位椎体的下终板平行的腹部疾病患者111例作为对照组，其中男87例，女24例，年龄为17.8±1.7岁（14~20岁）。LDH组在腰椎CT片上测量L3-4、L4-5、L5-S1关节突关节角度（作一直线通过椎间盘中点连接棘突基底部中点作为腰椎矢状轴，通过上关节突内外点作一连线，一侧连线与腰椎矢状轴相交所形成的角度即为一侧关节突关节角度），双侧角度之差>10°作为FT的衡量标准。对照组在腹部CT片上测量L3-4、L4-5、L5-S1关节突关节角度。结果：LDH组各节段的关节突关节角度的平均值与对照组比较无明显差异（P>0.05）。52例LDH患者中，L3-4节段出现FT的患者19例，L4-5节段出现FT 27例，L5-S1节段出现FT 24例；而对照组111例患者中相对应节段出现FT的患者分别为19例、28例、18例，LDH组各节段FT出现的概率明显高于对照组（P<0.05）。在LDH组34例L4/5椎间盘突出的患者中，15例出现FT；19例L5/S1椎间盘突出患者中，13例出现FT；椎间盘突出节段FT出现的概率明显高于对照组相应节段（P<0.05）。结论：在青少年LDH患者的下腰椎中FT发生率显著高于普通人群，与青少年LDH的发生存在一定的相关性。 |
Analysis of facet tropism of lower lumbar spine in adolescents with lumbar disc herniation |
| 英文关键词:Lumbar disc herniation Adolescents Facet joint Asymmetric Facet tropism |
| 英文摘要: |
| 【Abstract】 Objectives: To measure the angle of the lower lumbar facet joints in adolescents with lumbar disc herniation(LDH), and to observe the facet tropism(FT). Methods: This was a retrospective cohort study of patients with LDH or abdominal disease who were admitted to our hospital from August 2012 to August 2018. A total of 52 patients was included in LDH group, including 42 males and 10 females with an average age of 17.9±1.4. There were 33 patients with L4/5 disc herniation, 18 patients with L5/S1 disc herniation, one patient with L4/5 and L5/S1 disc herniation, including 24 patients with disc herniation toward the middle, 18 toward the left side, 11 toward the right side. There were 111 patients in control group, including 87 males and 24 females with an average age of 17.8±1.7. The facet joint angles of the L3-4, L4-5 and L5-S1 segment in LDH group were measured on the CT image of the lumbar spine. A line was made to connect the midpoint of the basal spinous process through the center of the intervertebral disc as the midsagittal line. This line was parallel to the lower endplate of the upper vertebral body and served as the sagittal axis of the lumbar vertebra. Another line drawn between the anteromedial and posterolateral edges of the bilateral superior articular facets was defined as the facet line. The angle between the 2 lines was the facet joint angle. FT was defined as asymmetry of >10° between the left and right side. In control group(abdominal CT group), the facet joint angles of L3-4, L4-5 and L5-S1 were measured on the CT picture of the abdomen, and the measurement method was as follows: the planes of the abdominal CT through the intervertebral disc and parallel to the lower endplate of the upper vertebral body were selected. And the remaining measurement methods and indicators were the same as those of LDH group. Results: There was no significant difference in the average fact angle of each segment between LDH group and control group(P>0.05). In LDH group, 19 patients had FT in L3/4 segment, 27 patients had FT in L4/5 segment and 24 patients had FT in L5/S1 segment. In control group, there were 19 patients, 28 patients and 18 patients with FT in corresponding segment. The probability of occurrence of FT in each segment of LDH group was significantly higher than that in control group (P<0.05). About 34 patients with L4/5 disc herniation in LDH group, FT appeared in 15 patients. Among the 19 patients with L5/S1 disc herniation, FT appeared in 13 patients. There was a significant difference(P<0.05) when FT appeared in the corresponding segment compared with that in control group(P<0.05). Conclusions: FT is common in the lower lumbar spine of adolescents with LDH, which is correlated with LDH in adolescents. |
| 投稿时间：2018-11-14 修订日期：2019-03-22 |
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