Murtagh F R, Paulsen R D, Rechtine G R
Department of Radiology, University of South Florida, College of Medicine, Tampa 33612.
J Spinal Disord. 1991 Mar;4(1):86-9.
The correlation of posterior intervertebral (facet) joint tropism (asymmetry), degenerative facet disease, and intervertebral disc disease was reviewed in a retrospective study of magnetic resonance images of the lumbar spine from 100 patients with complaints of low back pain and sciatica. Of the 27 of 100 (27%) of patients discovered to have disc disease (either herniation of nuclear material or bulge) at the L4-5 level, an approximately equal number had facet tropism (14 of 27) as did not (13 of 27). Of the 27 of 100 (27%) patients noted to have disc disease at the L5-S1 level, slightly more (16 of 21) had facet tropism than did not (11 of 27). Of the 65 of 100 (65%) of patients who had facet degenerative disease at the L4-5 level, an approximately equal number had facet tropism (33 of 65) as did not (32 of 100). At the L5-S1 level there was slightly more of a difference, with 25 of 41 having facet degenerative joint disease and tropism and 16 of 41 without it. This study raises questions as to the significance of facet joint tropism in intervertebral disc disease and degenerative facet joint disease but did show that asymmetry of the posterior intervertebral joint is far more common than previously thought: 50% of patients were found to have asymmetric facets at the L5-S1 level and 42% at the L4-5 level.
在一项对100例有腰痛和坐骨神经痛症状患者的腰椎磁共振图像的回顾性研究中，对椎间（小关节）关节不对称性、小关节退变疾病和椎间盘疾病之间的相关性进行了评估。在100例患者中，有27例（27%）在L4 - 5水平发现有椎间盘疾病（包括髓核突出或膨出），其中有小关节不对称的患者数量（27例中的14例）与没有小关节不对称的患者数量（27例中的13例）大致相等。在100例患者中，有27例（27%）在L5 - S1水平发现有椎间盘疾病，有小关节不对称的患者略多于没有小关节不对称的患者（27例中的16例对比27例中的11例）。在100例患者中，有65例（65%）在L4 - 5水平有小关节退变疾病，其中有小关节不对称的患者数量（65例中的33例）与没有小关节不对称的患者数量（100例中的32例）大致相等。在L5 - S1水平，差异略大一些，41例中有25例有小关节退变疾病和不对称，41例中有16例没有。这项研究引发了关于小关节不对称在椎间盘疾病和小关节退变疾病中的意义的疑问，但确实表明椎间关节不对称比之前认为的更为常见：50%的患者在L5 - S1水平有不对称小关节，42%的患者在L4 - 5水平有不对称小关节。
