Eubanks Jason David, Toy Jason O, Messerschmitt Patrick, Cooperman Daniel R, Ahn Nicholas U
Department of Orthopedics, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.
Orthopedics. 2009 Dec;32(12):893. doi: 10.3928/01477447-20091020-11.
Inadequate separation of the L4-S1 facets predisposes individuals to spondylolytic defects. We proposed that decreased interfacet separation is a risk factor for increased lumbar degenerative disease. This study examined the correlation between interfacet distance and degenerative disease of the lumbar spine. Four hundred forty-four cadaveric lumbar spines were examined for evidence of lumbar facet arthrosis and disk degeneration. Arthrosis at each level was graded from 0 to 4 on a continuum from no arthritis to complete ankylosis. These results were then examined in relation to interfacet spread. Interfacet distances were measured at each level (L1-S1). The difference in interfacet spread (L4-S1) was then correlated to facet arthrosis and disk degeneration. In individuals younger than 50 years (n=251), increased interfacet spread (L4-S1) was associated with less facet arthrosis at the L5/Sl level (P<.05). Similarly, in individuals younger than 40 years (n=149), increased interfacet spread (L4-S1) was associated with less disk degeneration at the L5/S1 level (P<.03). Insufficient increase in interfacet distances (L4-S1) correlates with a greater risk of developing and maintaining spondylolytic defects. Similarly, this study suggests that increased interfacet spread (L4-S1) protects against early degenerative changes at the L5/Sl level. The more pyramidal the L4-S1 facet cascade, the lower the arthrosis. This effect appears early in the degenerative process before facet arthrosis and disk degeneration have become ubiquitous. In individuals younger than 50 years, increased interfacet distance correlates with less L5/Sl facet arthrosis.
L4 - S1关节突分离不充分使个体易患椎弓峡部裂性缺损。我们提出关节突分离减少是腰椎退行性疾病增加的一个危险因素。本研究探讨了关节突间距与腰椎退行性疾病之间的相关性。对444具尸体腰椎进行检查，以寻找腰椎小关节骨关节炎和椎间盘退变的证据。每个节段的骨关节炎从无关节炎到完全强直连续分级为0至4级。然后将这些结果与关节突间距进行关联分析。在每个节段（L1 - S1）测量关节突间距。然后将关节突间距（L4 - S1）的差异与小关节骨关节炎和椎间盘退变进行相关性分析。在年龄小于50岁的个体（n = 251）中，关节突间距增加（L4 - S1）与L5/S1节段的小关节骨关节炎较少相关（P <.05）。同样，在年龄小于40岁的个体（n = 149）中，关节突间距增加（L4 - S1）与L5/S1节段的椎间盘退变较少相关（P <.03）。关节突间距（L4 - S1）增加不足与发生和维持椎弓峡部裂性缺损的风险增加相关。同样，本研究表明关节突间距增加（L4 - S1）可预防L5/S1节段的早期退变改变。L4 - S1关节突级联越呈金字塔形，骨关节炎越低。这种效应在小关节骨关节炎和椎间盘退变普遍出现之前的退变过程早期就已出现。在年龄小于50岁的个体中，关节突间距增加与L5/S1小关节骨关节炎较少相关。
