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峡部裂型成人椎体滑脱患者的椎间活动度是否增加?一项使用X线立体摄影测量法的配对比较研究。

Is there increased intervertebral mobility in isthmic adult spondylolisthesis? A matched comparative study using roentgen stereophotogrammetry.

作者信息

Axelsson P, Johnsson R, Strömqvist B

机构信息

Department of Orthopedics, Lund University Hospital, Lund, Sweden.

出版信息

Spine (Phila Pa 1976). 2000 Jul 1;25(13):1701-3. doi: 10.1097/00007632-200007010-00014.

Abstract

STUDY DESIGN

By roentgen stereophotogrammetric technique, the intervertebral mobility of the spondylolytic segment in eight patients was measured and compared with the mobility of eight nonspondylolytic patients matched according to sex, afflicted segment, and grade of disc degeneration.

OBJECTIVES

To compare the intervertebral mobility of a spondylolytic segment with the mobility of a segment without spondylolysis in adult patients with back pain.

SUMMARY OF BACKGROUND DATA

Evidenced by the resulting olisthetic deformity and supported by the outcome from prior investigations, spondylolysis is assumed to induce spinal segmental instability/hypermobility.

METHODS

After percutaneous application of tantalum indicators for roentgen stereophotogrammetric technique, the intervertebral translations of the spondylolytic fifth lumbar vertebra were measured in eight adult patients with low back pain and low-grade olisthesis. Eight other patients without spondylolysis but with low back pain presumably on degenerative basis were chosen for comparison and had an identical measuring procedure using roentgen stereophotogrammetric technique. The two groups were matched in pairs according to sex, afflicted segment, and grade of disc degeneration.

RESULTS

No significant difference was registered considering the intervertebral mobility for matched pairs in the two groups neither along the sagittal nor the vertical axis. The transverse translations were mostly negligible in both groups.

CONCLUSION

The spondylolytic defect in pars interarticularis does not cause permanent instability/hypermobility detectable in the adult patient with low back pain and low-grade olisthesis.

摘要

研究设计

采用X线立体摄影测量技术,对8例椎弓根峡部裂患者椎弓根峡部裂节段的椎间活动度进行测量,并与8例根据性别、受累节段和椎间盘退变程度匹配的非椎弓根峡部裂患者的活动度进行比较。

目的

比较成年腰痛患者椎弓根峡部裂节段与无椎弓根峡部裂节段的椎间活动度。

背景资料总结

椎弓根峡部裂导致脊柱滑脱畸形,先前的研究结果也支持这一点,因此推测椎弓根峡部裂会导致脊柱节段性不稳定/活动过度。

方法

在8例患有下腰痛和轻度椎体滑脱的成年患者中,经皮应用钽标记物用于X线立体摄影测量技术,测量椎弓根峡部裂的第五腰椎椎体的椎间移位。另外选择8例无椎弓根峡部裂但可能因退变导致下腰痛的患者进行比较,采用相同的X线立体摄影测量技术进行测量。两组患者根据性别、受累节段和椎间盘退变程度进行配对。

结果

两组配对患者沿矢状轴和垂直轴的椎间活动度均无显著差异。两组的横向移位大多可忽略不计。

结论

关节突间部的椎弓根峡部裂缺损不会导致成年下腰痛和轻度椎体滑脱患者出现可检测到的永久性不稳定/活动过度。

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