合并椎间盘突出的退变性腰椎滑脱椎间盘形态改变及其意义

Morphology and significance of lumbar disc in lumbar degenerative spondylolisthesis plus lumber disc herniation

中文关键词:  退变性腰椎滑脱  椎间盘突出症  椎间隙角度  椎间隙高度

英文关键词:Lumbar degenerative spondylolisthesis  Lumber disc herniation  Disc angular variation  Disc height

中文摘要:

  【摘要】 目的：观察合并椎间盘突出的退变性腰椎滑脱（lumbar degenerative spondylo-listhesis，LDS）患者的椎间盘影像学特点，探讨椎间盘退变程度、椎间隙角度及高度与退变性腰椎滑脱间的关系。方法：以2009年10月～2011年11月我院和石景山医院收治的合并L4/5椎间盘突出的退变性腰椎滑脱患者37例作为观察组，另选同期单纯L4/5椎间盘突出症患者38例作为对照组，对L4/5椎间盘退变程度按照Pfirrmann法分级，CT测定L4/5椎间盘正中矢状面的椎间隙角度和椎间隙高度，对所得数据进行统计分析。结果：观察组L4/5椎间盘MRI退变程度B、C、D、E级分别为1、25、8及1例，对照组分别为2、21、13及2例，两组椎间盘退变程度间差异没有显著性（P>0.05）；CT测量L4/5椎间隙角度观察组和对照组分别为3.08°±1.87°和6.48°±2.92°，对照组椎间隙角度明显大于观察组（P<0.05）；椎间隙高度观察组和对照组分别为8.46±1.81mm和9.38±2.46mm，两组间比较差异没有显著性（P>0.05）。结论：椎间隙角度减小，可能是退变性腰椎滑脱发病的重要因素之一。

英文摘要:

  【Abstract】 Objectives: To investigate the radiographic features of lumbar degenerative spondylolisthesis(LDS) plus lumber disc herniation(LDH) and the association between the degree of disc degeneration, disc angular variation as well as disc height and incidence of degenerative lumbar spondylolisthesis. Methods: 37 cases suffering L4/5 LDS plus lumber disc herniation (experimental group) and 38 cases with from L4/5 LDH alone (control group) from Peking University 3rd Hospital and Shi Jingshan Hospital between October 2009 and November 2011were reviewed retrospectively. The L4/5 parameters fromT2-weighted MRI and CT of 34 LDS and 37 LDH were collected. The degree of L4/5 disc degeneration was determined by using modified Pfirrmann scale. The angular variation and the heights of L4/5 disc were meassured and compared between experimental group and control group. Results: The number of cases with the degree of L4/5 disc degeneration showed as B, C, D and E were 1, 25, 8 and 1 respectively in experimental group, while those were 2, 21, 13 and 2 respectively in control group, which showed no significant difference with respect to the degree of disc degeneration（P>0.05）; the angular variation of L4/5 in experimental and control group was 3.08°±1.87° and 6.48°±2.92° respectively, which showed significant difference（P<0.05）; the disc height in experimental and control group was 8.46±1.81mm and 9.38±2.46mm respectively, which showed no significant difference（P>0.05）. Conclusions: Decrease of disc angular variation may induce lumbar degenerative spondylolisthesis.