青年轻度峡部裂性腰椎滑脱邻近节段间盘和小关节退变的MRI影像学研究

发布时间：2018-10-15 19:40

【摘要】：目的：通过观察对比青年轻度峡部裂性腰椎滑脱患者的MRI影像学等资料，，评估轻度峡部裂性腰椎滑脱对滑脱及邻近节段椎间盘和椎间小关节退变的影响。方法：回顾性分析2011年—2014年在吉林大学白求恩第二医院因下腰痛或坐骨神经痛就诊患者的腰椎MRI影像及诊疗资料。按病例样本纳入条件筛选出70例患者样本，选取其中30例出现临床症状的（下腰痛或坐骨神经痛）青年（20-29岁）轻度（Meyerding分度I°和II°）L5-S1节段峡部裂性腰椎滑脱患者作为病例组，选取其中40例出现临床症状的（下腰痛或坐骨神经痛）、无腰椎滑脱的青年（20-29岁）L5-S1节段腰椎间盘突出患者作为对照组，通过观察患者腰椎MRI（L3-4、L4-5、L5-S1节段）椎间盘失状平面和椎间小关节轴向平面的T1WI和T2WI序列图像，按Pfirrmann椎间盘退变MRI分级标准和椎间关节退化指数（FDI）来确定（L3-4、L4-5、L5-S1阶段）椎间盘和椎间小关节退变的严重程度。应用统计分析软件对数据进行分析处理，分析病例组和对照组患者滑脱与邻近节段椎间盘和椎间小关节退变之间的相关性。结果：青年轻度峡部裂性腰椎滑脱患者滑脱及邻近节段椎间盘和椎间小关节退变程度与对照组之间存在显著的统计学差异（P＜0.001）。青年轻度峡部裂性腰椎滑脱患者椎间盘和椎间小关节的退变程度在滑脱节段最为严重，远离滑脱节段的邻近节段受到的影响较小。结论：青年轻度峡部裂性腰椎滑脱患者,滑脱及邻近节段椎间盘和椎间小关节会发生退变，并且距主要滑脱部位越近，退变程度越严重。
[Abstract]:Objective: to evaluate the effect of mild isthmic spondylolisthesis on spondylolisthesis and adjacent intervertebral disc and intervertebral facet degeneration by observing and comparing the MRI imaging data of young patients with mild isthmic spondylolisthesis. Methods: MRI images of lumbar vertebrae and diagnosis and treatment of patients with low back pain or sciatica in Bethune second Hospital of Jilin University from 2011 to 2014 were analyzed retrospectively. A total of 70 patients were selected from 70 patients with clinical symptoms (low back pain or sciatica) (20-29 years old) with mild (Meyerding grade I 掳and II 掳) L5-S1 isthmic spondylolisthesis as the case group. Forty patients with clinical symptoms (lower back pain or sciatica) and young people without lumbar spondylolisthesis (20-29 years old) with L5-S1 segment lumbar disc herniation were selected as control group. The T1WI and T2WI sequences of lumbar MRI (L3-4, L4-5 and L5-S1 segments) of the lumbar disc and the axial plane of intervertebral facet joint were observed. The severity of intervertebral disc degeneration and intervertebral facet joint degeneration was determined according to Pfirrmann MRI grading standard and intervertebral joint degeneration index (FDI) (L3-4 L4-5 L5-S1 stage) and intervertebral facet joint degeneration. The data were analyzed by statistical analysis software. The correlation between slippage and adjacent intervertebral disc and intervertebral facet degeneration was analyzed in the case group and control group. Results: the degree of degeneration of lumbar spondylolisthesis and adjacent intervertebral disc and intervertebral facet joint in young patients with mild isthmic spondylolisthesis was significantly different from that in control group (P < 0.001). The degree of degeneration of intervertebral disc and intervertebral facet joint in young patients with mild isthmic spondylolisthesis was the most serious in the spondylolisthesis segment and the influence on the adjacent segment far away from the spondylolisthesis segment was small. Conclusion: in young patients with mild isthmic spondylolisthesis, spondylolisthesis and adjacent intervertebral disc and intervertebral facet joints will degenerate, and the closer to the main spondylolisthesis site, the more serious the degenerative degree is.
【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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