动态磁共振成像参数与腰椎不稳的关系

Relationship between lumbar instability and radiographic parameters：a kinetic MRI report

中文关键词:  动态MRI  腰椎不稳  椎间盘退变  小关节骨关节炎  黄韧带肥厚

英文关键词:Kinetic MRI  Lumbar instability  Disc degeneration  Facet joint osteoarthritis  Ligamentｕｍ flavum hypertrophy

中文摘要:

  【摘要】 目的：探讨腰椎不稳与脊柱功能单元中的动态磁共振成像参数（椎间盘退变、小关节骨关节炎及黄韧带肥厚）之间关系。方法：按Kong的标准诊断为腰椎不稳患者79例（237个脊柱功能单元），采用动态MRI在患者中立及过屈、过伸３个体位成像。测定L3／L4、L4／L5及L5／S1椎间盘退变（Ⅰ～Ⅴ级）、小关节骨关节炎（1～4级）、黄韧带肥厚（>3mm为黄韧带肥厚阳性）参数，评估其与腰椎不稳的相关性。结果：L4／L5节段不稳（36个）的发生较L3／L4（18个）及L5／S1节段多（25个）。椎间盘退变、小关节骨关节炎以及黄韧带肥厚（+）均与L3／L4、L4／L5、L5／S1　３个节段腰椎不稳相关（P<0.05）。结论：Ⅳ级椎间盘退变、3级小关节骨关节炎及黄韧带肥厚（+）分别与腰椎不稳的形成有关，在诊断腰椎不稳时，动态MRI及其３个参数具有辅助诊断的作用。

英文摘要:

  【Abstract】 Objective：To evaluate the relationship between lumbar instability and parameters in the functional spinal unit including disc degeneration，facet joint osteoarthritis and ligamentum flavum hypertrophy.Method：According to the Kong′s criteria，79 cases（a total of 237 functional spinal units）with lumbar instability were subjected to MRI under neutral，flexion and extension position.Segmental range of motion was measured at three levels（L3/L4，L4/L5，L5/S1）.Then three radiographic parameters including disc degeneration（gradeⅠ-Ⅴ），facet joint osteoarthritis（grade 1-4） and ligamentum flavum hypertrophy（>3mm indicating the presence of ligamentum flavum hypertrophy）　were used to evaluate the relationship between them and lumbar instability.Result：L4/5 instability（36 cases）　was more prevalent than L3/4（18 cases）　and L5/S1（25 cases）.Disc degeneration，facet joint osteoarthritis and ligamentum flavum hypertrophy all showed relationship with L3/L4，L4/L5 and L5/S1 instability（P<0.05）.Conclusion：Radiographic parameters including grade Ⅳdisc degeneration，grade 3 facet joint osteoarthritis and ligamentum flavum hypertrophy（+） participate in the development of lumbar instability，which can be used to determine lumbar instability.