Cassidy J D, Loback D, Yong-Hing K, Tchang S
Department of Orthopaedics, Royal University Hospital, University of Saskatchewan, Saskatoon, Canada.
Spine (Phila Pa 1976). 1992 May;17(5):570-4.
A study of 136 patients with lumbar intervertebral disc herniation was undertaken to test the hypothesis that asymmetry of the facet joints is associated with the level, type, and side of herniation. Fifty cases of central herniation and 86 cases of lateral herniation, all at the L4-5 or L5-S1 levels, were studied by computed tomographic scans. Adjacent (nonherniated) levels were used as controls. The facet joint angles were measured at the L4-5 and L5-S1 levels of the control, central, and lateral herniated levels. The results showed a similar degree of facet joint asymmetry at all levels. In cases of lateral herniation, there was a significant difference in the facet angle between the herniated and nonherniated side at the L5-S1 level, but not the L4-5 level. The mean difference, however, was less than 3 degrees and not considered to be clinically relevant. There was no difference in the distribution of the more coronally or sagittally facing facet joints with respect to the side of lateral herniation. These results do not support the hypothesis that facet asymmetry is associated with lumbar intervertebral disc herniation.
开展了一项针对136例腰椎间盘突出症患者的研究，以验证小关节不对称与突出的节段、类型及侧别相关这一假说。通过计算机断层扫描对50例中央型突出和86例侧方型突出患者进行研究，所有患者突出节段均在L4 - 5或L5 - S1水平，以相邻（未突出）节段作为对照。在对照、中央型突出和侧方型突出节段的L4 - 5及L5 - S1水平测量小关节角度。结果显示，所有水平的小关节不对称程度相似。在侧方型突出病例中，L5 - S1水平突出侧与未突出侧的小关节角度存在显著差异，但L4 - 5水平无差异。然而，平均差异小于3度，不认为具有临床相关性。在侧方型突出侧，冠状面或矢状面朝向的小关节分布无差异。这些结果不支持小关节不对称与腰椎间盘突出症相关的假说。
