Abu-Leil Saher, Floman Yizhar, Bronstein Yigal, Masharawi Youssef
Spinal Research Laboratory, Department of Physical Therapy, Sackler Faculty of Medicine, The Stanley Steyer School of Health Professions, Tel-Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel.
Israel Spine Center, Assuta Hospital, Habarzel St 20, Tel Aviv, Israel.
Eur Spine J. 2016 Aug;25(8):2535-45. doi: 10.1007/s00586-016-4673-3. Epub 2016 Jun 27.
Most morphometric studies on lumbar degenerative spondylolisthesis (DS) have focused solely on the L4-L5 slipped level, neglecting the shape of the entire lumbar segments. The purpose of this study was to present a morphometric analysis of the entire lumbar IVDs and VBs in DS.
Out of 500 lumbar CTs, the first 100 CTs, 50 with DS at L4 and 50 age- and sex-matched control CTs, were randomly selected. All lumbar IVD and VB heights, widths, lengths and sagittal wedging as well as lumbar lordosis (LL) and sacral inclination (SI) were measured and relevant ratios calculated. The prevalence of lumbar vertebral osteophyte was also measured.
A total of 6700 measurements were taken. Age, height, weight and BMI had no effect on all parameters. Compared with controls, in females with DS, the majority of IVDs were flatter, with increased kyphotic wedging at L1-L2 (Δ1.3°) and L2-L3 (Δ1.8°), turning to lordotic wedging at L3-L4 (Δ5.9°), and decreased lordotic wedging at L4-L5 (Δ2.7°) and L5-S1 (Δ5.3°). The posterior IVD/VB ratio of all lumbar levels, middle IVD/VB ratio of L3-S1 and anterior IVD/VB ratio of L4-S1 were smaller. In males with DS, the L2-L3 IVD manifested more kyphotic wedging (Δ3.8°), the L4 VB wedging was more lordotic (Δ2.4°) and all L4-L5 IVD/VB ratios and L3-L4 middle and posterior IVD/VB ratios were smaller.
Individuals with DS have a more generalized degenerative disc disease on all lumbar vertebral levels, characterized by decreased disc space heights and kyphotic posture of the upper lumbar segments, occurring more predominantly in females than in males with DS.
大多数关于腰椎退行性滑脱（DS）的形态学研究仅关注L4 - L5滑脱节段，而忽略了整个腰椎节段的形态。本研究的目的是对DS患者的整个腰椎椎间盘（IVD）和椎体（VB）进行形态学分析。
在500例腰椎CT中，随机选取前100例，其中50例L4节段患有DS，50例为年龄和性别匹配的对照CT。测量所有腰椎IVD和VB的高度、宽度、长度和矢状楔形变，以及腰椎前凸（LL）和骶骨倾斜度（SI），并计算相关比率。还测量了腰椎椎体骨赘的发生率。
共进行了6700次测量。年龄、身高、体重和体重指数对所有参数均无影响。与对照组相比，患有DS的女性中，大多数IVD更扁平，L1 - L2（Δ1.3°）和L2 - L3（Δ1.8°）的后凸楔形变增加，L3 - L4转为前凸楔形变（Δ5.9°），L4 - L5（Δ2.7°）和L5 - S1（Δ5.3°）的前凸楔形变减少。所有腰椎节段的IVD/VB后比率、L3 - S1的IVD/VB中比率以及L4 - S1的IVD/VB前比率均较小。患有DS的男性中，L2 - L3的IVD表现出更多的后凸楔形变（Δ3.8°），L4椎体的楔形变更呈前凸（Δ2.4°），所有L4 - L5的IVD/VB比率以及L3 - L4的IVD/VB中后比率均较小。
患有DS的个体在所有腰椎节段都有更广泛的椎间盘退变疾病，其特征为椎间盘间隙高度降低和上腰椎节段的后凸姿势，在患有DS的女性中比男性更常见。
