摘要
目的 探讨胸腰段椎间盘突出症（thoracolumbardisc herniation,TLDH）和休门病的内在联系以及休门病在TLDH发病中的作用.方法 2006年6月至2010年6月,以45例因TLDH（T10-11～L2-3）手术的患者作为研究组（TLDH组）,及同期手术的低位（L3-4～L5S1）腰椎间盘突出症（1umbardisc herniation,LDH）患者中随机抽取45例作为对照组（LDH组）.通过复习其CT、MRI和X线片,对比两组合并休门病和各种影像学休门样改变的比例,并比较两组的胸腰段后凸角度.进一步在TLDH组内部分别对比存在各种休门样改变的节段和无休门样改变节段合并椎间盘突出的比例.结果 TLDH组97.8%（44/45）的患者均合并休门病,LDH组仅为26.7%（12/45;x2=48.403,P=0.000）.TLDH组出现各种休门样改变的比例均高于LDH组,分别为许莫结节66.7%（30/45）和15.6%（7/45;x2=24.278,P=0.000）,终板不规则88.9%（40/45）和15.6%（7/45;x2=48.496,P=0.000）,椎体后缘离断75.6%（34/45）和13.3%（6/45;x2=35.280,P=0.000）,相邻椎体楔形变93.3%（42/45）和0%（x2=78.750,P=0.000）.TLDH组患者平均胸腰段后凸角15.8°±6.9°,LDH组为4.8°±4.0°（t=7.703,P＜0.001）.TLDH组内,存在许莫结节（32.8%,39/119;x2=9.276,P=0.002）,终板不规则（50.0%,55/110;x2=22.255,P=0.000）,椎体后缘离断（100%,40/40;x2=69.421,P=0.000）和椎体楔形变（39.5%,58/147;x2=14.631,P=0.000）的节段发生椎间盘突出的比例均高于无休门样改变的节段（9.1%,4/44）.结论 胸腰段椎间盘突出症与休门病关系密切,前者可能是后者的一种表现.许莫结节、终板不规则、椎体楔形变,尤其是椎体后缘离断,与椎间盘突出的发生有关.
Objective To explore the relationship between thoracolumbar disc herniation （TLDH） and Scheuermann1＇s disease （SD）,as well as the role of SD in the etiology of TLDH.Methods From June 2006 to June 2010,45 patients with TLDH （T10-11-L2-3） underwent surgery in our department.Forty-five patients with lower lumbar disc herniation （LDH,L3-4-L5S1） acted as controls.The incidence of SD and Scheuermann＇s signs of these patients were examined by reviewing CT,MRI and Ⅹ-ray films.The thoracolumbar kyphotic angles of the two groups were compared.Furthermore,in TLDH group,the incidence of disk herniation within segments with the Scheuermann＇s signs was compared to that within segments without Scheuermann＇s signs.Results All except one patient in TLDH group（97.8%） had been associated SD while the incidence of SD in LDH group was only 26.7%.The incidence of all Scheuennann＇s signs was higher in TLDH group than that in LDH group.The average thoracolumbar kyphotic angle of TLDH group was 15.8°±6.9° while that of LDH group was 4.8°±4.0°.In TLDH group,the incidence of disc herniation within segments with Scheuermann＇s signs was all higher than that within segments without Scheuermann＇s signs.Conclusion There is a close relationship between TLDH and SD,suggesting that TLDH is probably a manifestation of SD.Schmorl＇s node,irregular end plate,wedge-shaped vertebra and especially,posterior bony edge separation,are associated with disc herniation.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2011年第5期436-441,共6页
Chinese Journal of Orthopaedics
关键词
胸椎
腰椎
椎间盘移位
SCHEUERMANN病
Thoracic vertebrae
Lumbar vertebrae
Intervertebral disk displacement
Scheuermann＇s disease
