退行性腰椎滑脱临近节段椎间盘退变和关节突关节角度相关研究

目的:探讨退行性腰椎滑脱(DLS)临近节段椎间盘退变程度和关节突关节角度之间的关系。方法:选取我院2012年6月至2016年6月收治的120例DLS患者作为DLS组,另外选取来我院接受体检的健康者120例作为对照组,选择CT进行关节突关节角和腰椎滑脱度的测量,使用MRI的T2像对椎间盘进行Pfirrmann退变分级。结果:DLS组的各节段关节突关节角度均小于对照组(P0.05);DLS组不同滑脱程度的L2/3、L3/4、L5/S1节段关节突关节角度的比较,差异无统计学意义(P0.05);DLS组L2/3、L3/4、L5/S1节段不同椎间盘退变等级间的滑脱程度无显著性差异(P0.05)。L2/3和L3/4节段不同椎间盘退变程度间关节突关节角度差无显著性差异(P0.05),L5/S1节段不同椎间盘退变程度间关节突关节角度差有统计学差异(P0.05)。结论:退行性腰椎滑脱临近节段关节突关节角度明显小于正常人,且临近节段关节突关节的角度并未随着腰椎滑脱程度的加重而改变,退行性腰椎滑脱患者滑脱临近节段椎间盘退变与关节突关节的矢状化程度无关,但L5/S1关节突关节角度不对称性会影响到同节段椎间盘退变程度。

Correlational Research between Adjacent Disc Degeneration and Facet Joint Angle in Patients with Degenerative Lumbar Spondylolisthesis

ABSTRACT Objective: To explore the relationship between adjacent disc degeneration and facet joint angle in patients with degenerative lumbar spondylolisthesis(DLS). Methods: 120 patients with DLS in our hospital from June 2012 to June 2016 were selected as DLS group, in addition, 120 healthy persons were selected as control group.Facet joint angle and lumbar spondylolisthesis were measured with CT, pfirrmann degeneration of intervertebral discs were detected using MRI images of T2. Results: The facet joint angles of each segment of the DLS group were less than those of the control group (P<0.05). There was no significant difference in facet joint angles between L2/3, L3/4, and L5/S1 with different degrees in DLS groups (P>0.05). There was no significant difference in slip degree between different degrees of intervertebral disc degeneration in L2/3, L3/4 and L5/S1 segment in DLS group (P>0.05). There was no significant difference in the facet joint angle between the L2/3 and L3/4 segments with different degrees of intervertebral disc degeneration (P>0.05), there was significant difference in the facet joints angle between the different degrees of intervertebral disc degeneration in L5/S1(P<0.05). Conclusion: The facet joint angle of in patients with degenerative lumbar spondylolisthesis was significantly less than that of the normal person, and the facet joint angle of the adjacent segment does not change with the degree of lumbar spondylolisthesis.The degeneration of adjacent intervertebral discs in patients with degenerative spondylolisthesis is not related to the degree of sagittal joint,however, the asymmetry of facet joint angle of L5/S1 can affect the degree of degeneration of the segmental intervertebral disc.