腰椎退变性侧凸患者椎间盘退行性变的影像学观测

Imaging observation of intervertebral disc degeneration and degenenrative lumbar scoliosis

中文关键词:  退变性腰椎侧凸  腰椎前凸  椎间盘不对称指数  椎间盘退变

英文关键词:Degenenrative lumbar scoliosis  Lumbar lordosis  Ｔhe asymmetric disc index  Ｉntervertebral disc degeneration

中文摘要:

  【摘要】 目的：评价退变性腰椎侧凸患者椎间盘退变程度与腰椎侧凸角度、腰椎前凸角度的相关性。方法：本组共包括84例退变性腰椎侧凸患者（平均年龄为64.1±5.3岁），在X线片上测量其顶椎间盘（如顶椎为椎体则取该椎体下位椎间盘）及其相邻上下椎间盘（共252个椎间盘）的不对称指数，MRI T2加权像上测量椎间盘内髓核与脑脊液的平均相对信号强度。应用Spearmann相关性分析研究椎间盘不对称指数与腰椎侧凸角的相关性、平均相对信号强度与腰椎前凸角的相关性。结果：84例退变性腰椎侧凸患者中，凸侧三个椎间盘的高度平均为40.1±1.8mm；凹侧平均为38.3±1.1mm，凸凹侧椎间盘高度比较差异有显著性（P＜0.05）。椎间盘不对称指数的平均值为0.042±0.018，经Spearman相关分析椎间盘不对称指数与侧凸Cobb角之间有明显正相关性（P＜0.05）；T2加权像上退变性腰椎侧凸髓核平均相对信号强度Ⅰ级8例，Ⅱ级27例，Ⅲ级32例，Ⅳ级17例；经Spearman相关分析该平均相对信号强度与腰椎前凸Cobb角之间有相关性（P＜0.05）。结论：退变性腰椎侧凸的侧凸角与椎间盘退变的不对称性程度存在正相关，腰椎前凸角减少与椎间盘退变程度有相关性。

英文摘要:

  【Ａbstract】 Objective：Ｔo investigate the relationship between lumbar intervertebral disc degeneration and degree of scoliosis，segmental lordosis in degenerateive lumbar scoliosis.Ｍethod：84 cases with degenerative lumbar scoliosis（mean age，64.1±5.3 years） were recruited，a total of 252 discs were inverstigated including disc asymmetric index between apex intervertebral disc and adjacent discs as well as the average relative signal intensity in T2WI sagittal image between nucleus pulpous in lumbar disc and cerebrospinal fluid. Spearmann analysis was used to evaluate the correlation between disc asymmetric index and degrees of scoliosis，average relative signal intensity and lumbar lordosis.Result：The average intervertebral height was 40.1±1.8 mm in the convex side and 38.3±1.1 mm in the concave side，which showed significant difference between two side（P＜0.05）. The disc asymmetric index was 0.042±0.018，which showed positive correlation between disc asymmetric index and degree of scoliosis（P＜0.05）.The average relative signal intensity of lumbar intervertebral disc and cerebrospinal fluid in T2WI sagittal image were as follows：Ⅰ level 8 cases，Ⅱ level 27 cases，Ⅲ level 32 cases and Ⅳ level 17 cases, with the average relative signal intensity showing negative relationship with lumbar lordosis（P＜0.05）.Ｃonclusion：The degree of scoliosis is positive related to the disc asymmetric index, and the decrease of segmental lordosis is associated with the degree of disc degeneration.