Kalichman Leonid, Guermazi Ali, Li Ling, Hunter David J, Suri Pradeep
Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA, USA.
J Spinal Disord Tech. 2010 Apr;23(2):101-5. doi: 10.1097/BSD.0b013e31819afb80.
Cross-sectional study.
To evaluate the association between lumbar spine facet joint orientation, facet joint tropism, and spondylolysis identified by multidetector computed tomography (CT) in the community-based Framingham Heart Study.
The association between lumbar spondylolysis and facet orientation and tropism remains unclear.
This study was an ancillary project to the Framingham Heart Study. Three thousand five hundred twenty-nine participants of the Framingham Heart Study aged 40 to 80 years underwent multidetector CT imaging to assess aortic calcification. One hundred ninety-one subjects were included in this ancillary study. Facet joint features and spondylolysis were evaluated on CT scans. The final analyzed sample included 104 men with mean age 51.90+/-11.25 years and 84 women with mean age 53.61+/-10.20 years. The association between spondylolysis and facet orientation and tropism was examined using univariate and multivariate analyses.
Spondylolysis was prevalent in 11.5% of the total population. chi2 test demonstrated a significant sex difference in prevalence of spondylolysis (P=0.0154), with almost 3 times higher prevalence among men. There was no statistically significant difference in facet orientation and continuous facet tropism between individuals with and without spondylolysis at the L5 level (P=0.49 to 0.91). After adjustment for age, sex, and body mass index, no significant association between the occurrence of spondylolysis and facet orientation and tropism was found. In the studied sample the prevalence of facet joint osteoarthritis was significantly higher in individuals with spondylolysis than in those without spondylolysis at both sides of L4-L5 spinal level (P=0.044 at the right side and P=0.003 at the left side) and at left side of L5-S1 level (P=0.038).
We did not find an association between facet orientation, facet tropism, and spondylolysis. One of the possible explanations for this is that the high prevalence of facet joint osteoarthritis in individuals with spondylolysis in the studied sample might have led to diminished differences in facet orientation.
横断面研究。
在基于社区的弗明汉心脏研究中，评估多排计算机断层扫描（CT）所确定的腰椎小关节方向、小关节不对称性与椎弓根峡部裂之间的关联。
腰椎椎弓根峡部裂与小关节方向及不对称性之间的关联仍不明确。
本研究是弗明汉心脏研究的一个附属项目。弗明汉心脏研究中3529名年龄在40至80岁的参与者接受了多排CT成像以评估主动脉钙化情况。191名受试者被纳入该附属研究。在CT扫描上评估小关节特征和椎弓根峡部裂情况。最终分析样本包括104名平均年龄为51.90±11.25岁的男性和84名平均年龄为53.61±10.20岁的女性。使用单因素和多因素分析来研究椎弓根峡部裂与小关节方向及不对称性之间的关联。
椎弓根峡部裂在总人口中的患病率为11.5%。卡方检验显示椎弓根峡部裂患病率存在显著的性别差异（P = 0.0154），男性患病率几乎是女性的3倍。在L5水平，有和没有椎弓根峡部裂的个体之间，小关节方向和连续小关节不对称性没有统计学上的显著差异（P = 0.49至0.91）。在对年龄、性别和体重指数进行调整后，未发现椎弓根峡部裂的发生与小关节方向及不对称性之间存在显著关联。在所研究的样本中，在L4 - L5脊柱水平两侧，有椎弓根峡部裂的个体小关节骨关节炎的患病率显著高于没有椎弓根峡部裂的个体（右侧P = 0.044，左侧P = 0.003），在L5 - S1水平左侧也有显著差异（P = 0.038）。
我们未发现小关节方向、小关节不对称性与椎弓根峡部裂之间存在关联。对此的一种可能解释是，在所研究样本中有椎弓根峡部裂的个体中，小关节骨关节炎的高患病率可能导致了小关节方向差异的减小。
