摘要
目的 探讨矢状化小关节角度(FJA)与退变性腰椎滑脱(DLS)之间的关系.方法 回顾性研究.2010年1月—2018年5月首都医科大学宣武医院骨科单节段L4/5 DLS住院患者89例纳入DLS组,按年龄分为A1、B1两亚组,A1组44例(男14例、女30例),年龄<65岁;B1组45例(男17例、女28例),年龄≥65岁.对照组100例为同期骨科门诊腰腿痛患者,性别、年龄与DLS组相当,但未见腰椎滑脱者.按年龄分为A2、B2两亚组,A2组54例(男18例、女36例),年龄<65岁;B2组46例(男15例、女31例),年龄≥65岁.在腰椎CT软组织窗测量各组L4/5和L3/4节段FJA,并应用SPSS 22.0统计学软件对患者FJA、小关节不对称(FT)程度和小关节退变分级之间的差异进行组间对比分析.结果 DLS组内,L3/4节段A1组和B1组FJA分别为54.73° ±7.26°和56.60° ±6.94°,差异无统计学意义(P>0.05);L4/5节段A1组、B1组FJA分别为58.43° ±10.41°和63.28° ±6.56°,差异有统计学意义(P<0.05).对照组内,L3/4节段A2和B2组FJA分别52.16° ±10.07°和54.66° ±8.66°,L4/5节段A2组、B2组FJA分别为45.36° ±7.78°和47.82° ±9.65°,差异均无统计学意义(P值均>0.05).DLS组与对照组L3/4、L4/5节段FJA比较,差异均有统计学意义(P值均<0.05).两组内各亚组间FT比较,L3/4与L4/5节段差异均无统计学意义(P值均>0.05);DLS组与对照组组间FT比较,在L4/5节段差异有统计学意义(P<0.05),在L3/4节段差异无统计学意义(P>0.05).在L4/5节段及L3/4节段,小关节退变程度DLS组均高于对照组,DLS组内B1组均高于A1组,差异均有统计学意义(P值均<0.01);而对照组内两亚组间比较差异均无统计学意义(P值均>0.05).结论 DLS患者具有更加矢状化的FJA,这可能是疾病发生发展过程中二次重塑的结果.
Objective To explore the relationship between sagittal facet joint angle (FJA) and degenerative lumbar spondylolisthesis (DLS).Methods Retrospective study.Eighty-nine patients with single-segment L4/5 DLS in the Department of Orthopedics,Xuanwu Hospital,Capital Medical University from January 2010 to May 2018 were enrolled as the DLS group.According to age and course,they were divided into A1 and B1 subgroups,44 patients in A1 group (14 males and 30 females),aged <65 years old;45 patients in B1 group (17 males and 28 females),aged ≥65 years old.In the control group,100 outpatients with lumbago and leg pain at the same period were matched with DLS group in sex and age,but no lumbar spondylolisthesis was found.According to the age and course of disease,54 cases (18 males and 36 females) were divided into A2 and B2 subgroups,and 46 cases (15 males and 31 females) were divided into B2 subgroups.FJA of L4/5and L3/4 were measured by soft tissue window of lumbar CT,and the differences of FJA,facet joint asymmetry (FT)and facet joint degeneration grading were analyzed by SPSS 22.0.Results In DLS group,FJA of L3/4 in A1 group and B1 group were 54.73°±7.26°and 56.60°± 6.94°,respectively.There was no significant difference (P >0.05).FJA of L4/5 in A1 group and B1 group were 58.43°±10.41°and 63.28°±6.56°,respectively.There was significant difference (P <0.05).In the control group,FJA of L3/4 in A2 and B2 groups were 52.16°±10.07°and 54.66°±8.66°,FJA of L4/5 in A2 and B2 groups were 45.36°±7.78°and 47.82°±9.65°,there were no significant differences (all P values >0.05).FJA of L3/4 and L4/5 between the two groups were compared,the differences were statistically significant (all P values <0.05).There were no significant differences in the distribution of FT between their subgroups in DLS and control groups in L3/4 and L4/5 (all P values >0.05).There was significant difference in the L4/5 between the DLS group and the control group (P <0.05),but no significant difference in the L3/4(P >0.05).In L4/5 and L3/4,the degree of degeneration of FJ in DLS group was higher than that in control group,while that in B1 group was higher than that in A1 group (all P values <0.01), and there was no significant difference between the two subgroups in control group (P >0.05).Conclusions DLS patients have a more sagittal FJA,which may be the result of secondary remodeling in the course of disease development.
作者
郭马超
鲁世保
孔超
孙祥耀
孙思远
Guo Maehao;Lu Shibao;Kong Chao;Sun Xiangyao;Sun Siyuan(Department ofOrthopedic,Capital Medical UniversityXuanwuHospital,Beijingl00053,China)
出处
《中华解剖与临床杂志》
2018年第5期377-382,共6页
Chinese Journal of Anatomy and Clinics
关键词
脊椎滑脱
腰椎
小关节角度
小关节不对称
小关节退变
Spondylolysis
Lumbar vertebrae
Facet joint angle
Facet tropism
Facet joint degeneration
