关节突关节角变化与退变性腰椎滑脱间关系的临床研究

发布时间：2018-04-20 06:39

本文选题：脊椎滑脱 + 椎间盘退行性变　；参考：《安徽医科大学》2016年硕士论文

【摘要】：目的探讨关节突关节角的改变与退变性腰椎滑脱(DLS)的发生之间的因果关系。方法回顾性选取2010年1月～2013年7月安徽医科大学附属省立医院骨科收治的100例单纯L4/5退变性滑脱患者作为DLS组,同期100例无腰腿痛和脊椎滑脱且性别、年龄与DLS组相匹配的正常患者作为对照组。2组均行站立位腰椎正侧位片及腰椎CT检查,在x线上测量腰椎滑脱Boxall指数；在CT图像上选取平行于L3/4、L4/5、L5/S1椎间隙上缘终板的关节面CT横断图像作为关节突关节的头侧部分；平行于L3/4、L4/5、L5/S1椎间隙下缘终板的关节面CT横断图像作为关节突关节的尾侧部分,并测量头尾侧关节突关节与椎体冠状面的夹角,并在CT骨窗下对头尾侧关节突关节的退变程度进行分级。结果DLS组L4/5头侧关节突关节角58.8±6.3°大于对照组的50.6±7.9°,尾侧关节突关节角56.2±6.1。大于对照组的47.1±7.8。,差异均具有显著性(P0.01)。DLS组患者L4/5头尾侧角度差值2.4±0.6°小于对照组的4.9±1.7。,差异有显著性(P0.01)。DLS组L4/5左右两侧关节突关节角不对称度7.8±2.0°大于对照组的5.1±1.6。,差异有显著性(P0.01)。按关节突关节退变等级将DLS患者分成3组,各组间滑脱Boxall指数差异有显著性(P0.05),而不同退变等级中头、尾侧关节突关节角度差异无显著性(P0.05)；结论关节突关节空间方向上的改变是退变性腰椎滑脱过程中应力作用下二次重塑的结果。
[Abstract]:Objective to investigate the causal relationship between the change of articular facet joint angle and the occurrence of degenerative lumbar spondylolisthesis. Methods from January 2010 to July 2013, 100 cases of simple L 4 / 5 degenerative spondylolisthesis treated in the Department of Orthopaedics, affiliated Provincial Hospital of Anhui Medical University were selected as DLS group. In the same period, 100 cases were without low back pain and spondylolisthesis and sex. The normal patients with age matched with DLS group were treated as control group (group 2). All the patients were examined by standing lumbar vertebrae and lumbar CT, and the Boxall index of lumbar spondylolisthesis was measured on the X ray of Lumbar Spondylolisthesis. The CT transection of the articular surface parallel to the upper marginal endplate of the intervertebral space of L3 / 4 / 5 / 5 / S1 was selected as the head part of the articular facet joint on CT images, and the CT transection image of the articular surface parallel to the L4 / 4 / L4 / 5 / L5 / S1 end plate of the lower margin of the intervertebral space was used as the tail part of the articular facet joint. The angle between the head and tail facet joint and the coronal plane of the vertebral body was measured, and the degree of degeneration of the head and tail facet joint was graded under the CT bone window. Results in DLS group, 58.8 卤6.3 掳of L4 / 5 head facet joint angle was higher than that of control group (50.6 卤7.9 掳), and 56.2 卤6.1 掳of caudal facet joint angle. There was significant difference in angle difference of L4 / 5 head and tail between the DLS group and the control group (2.4 卤0.6 掳vs 4.9 卤1.7.The difference was significant). There was a significant difference in the angle asymmetry between the L4 / 5 and DLS groups (7.8 卤2.0 掳vs 5.1 卤1.6.The difference was significant (P 0.01)). According to the grade of degenerative articular process, DLS patients were divided into three groups. The Boxall index of slippage was significantly different among the three groups (P 0.05), but the middle head of different grade of degeneration. Conclusion the spatial change of articular facet joint is the result of secondary remodeling under stress during degenerative lumbar spondylolisthesis.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R681.5

【参考文献】