仰卧位腰椎MRI小关节积液与退变性腰椎滑脱稳定性关系的研究

发布时间：2018-08-25 12:35

【摘要】：目的：分析退变性腰椎滑脱患者仰卧位MRI中L4-5腰椎小关节积液与侧卧过屈过伸侧位X线上腰椎不稳之间的相关性。方法：选取自2013年2月-2015年2月在吉林大学中日联谊医院骨科行仰卧位腰椎MRI和侧卧位过屈过伸位X线检查的67例L4-5腰椎退变性疾病患者，其中有L4-5退变性腰椎滑脱同时仰卧位腰椎MRI中显示关节积液量大于1mm患者为有积液组,有L4-5退变性腰椎滑脱仰卧位腰椎MRI中没有显示关节积液或关节积液量小于1mm的患者作为对照组。所有患者在仰卧位腰椎MRI T2加权序列上测量腰椎小关节积液和侧卧位过屈过伸位X线片上评估腰椎不稳。记录L4-5腰椎小关节积液量的大小和腰椎不稳滑移参数。以侧卧位过屈过伸位X线片为标准。将有积液组与对照组的年龄、性别、腰椎移动度、间盘退变分级、小关节炎分级、软骨退变分级、小关节软骨下骨化分级作比较，同时将有积液组内积液量与移位度进行相关性分析。结果：67例病人中，32例在侧卧位过屈过伸位X线片出现L4-5腰椎不稳，35例在站立位过屈过伸侧位X线上没有出现不稳。15例（22.39%）腰椎滑脱患者中可观察到腰椎小关节积液，平均滑移度是5.027±1.134mm，平均小关节积液数值是3.09mm。52例（77.61%）腰椎滑脱患者中没有观察到腰椎小关节积液或关节积液量小于1mm。有积液组与对照组之间的年龄比较差异无统计学意义（P0.05），，有积液组与对照组之间腰椎移动度、腰椎角度变化、腰椎间盘退变分级、小关节炎分级、软骨退变分级、小关节软骨下骨化分级差异有统计学意义（P0.05），有积液组积液量与腰椎移动度有相关性（r=0.919，P0.05）。结论：无积液组腰椎稳定性较有积液组腰椎稳定性更稳定，退变性腰椎滑脱腰椎小关节积液量与腰椎移动度正相关。
[Abstract]:Objective: to analyze the correlation between L4-5 lumbar facet joint effusion and lateral overflexion extension X-ray instability in supine position MRI of degenerative lumbar spondylolisthesis. Methods: from February 2013 to February 2015, 67 patients with lumbar degenerative disease of L4-5 were examined by MRI in supine position and flexion and extension position in lateral position in Department of Orthopaedics, Sino-Japanese Friendship Hospital, Jilin University, from February 2013 to February 2015. Among them, L4-5 degenerative lumbar spondylolisthesis and supine lumbar MRI showed that the amount of joint effusion was larger in patients with 1mm than that in patients with 1mm. Patients with L4-5 degenerative lumbar spondylolisthesis in supine position had no joint effusion or joint effusion less than 1mm in supine position as control group. Lumbar instability was evaluated on MRI T2 weighted sequence in supine lumbar spine and lateral overflexion and extension position. L4-5 lumbar facet joint fluid volume and lumbar instability slip parameters were recorded. X-ray film of lateral position was taken as standard. Age, sex, lumbar mobility, disc degeneration, small arthritis, cartilage degeneration, subchondral ossification were compared between the hydrops group and the control group. At the same time, the correlation between the amount of fluid accumulated and the degree of displacement in the group with hydrops was analyzed. Results L4-5 lumbar vertebrae instability was found in 32 of 67 cases (22.39%) of lumbar spondylolisthesis in lateral supine position, and no instability of lumbar vertebrae was found in 35 cases of L4-5 unstable lumbar spine in standing position. 15 cases (22.39%) of lumbar spondylolisthesis were found to have effusion of lumbar facet joint. The average slip degree was 5.027 卤1.134mm, and the mean value of fluid accumulation of facet joint was 77.61% (77.61%) of lumbar spondylolisthesis. No effusion or fluid was found in lumbar facet joint less than 1 mm. in the patients with lumbar spondylolisthesis, the mean slip degree was 5.027 卤1.134mm. There was no significant difference in age between the hydrops group and the control group (P0.05). There was no significant difference in lumbar mobility, lumbar angle, lumbar disc degeneration, small arthritis, cartilage degeneration between the hydrops group and the control group. There was significant difference in subchondral ossification grade of facet joint (P0.05), and there was a correlation between fluid accumulation and lumbar mobility in the group with effusion (r = 0.919 P 0.05). Conclusion: the stability of lumbar vertebrae in the group without fluid is more stable than that in the group with fluid. The amount of fluid in the lumbar facet joint of degenerative lumbar spondylolisthesis is positively correlated with the degree of lumbar mobility.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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