Lv Xin, Liu Yuan, Zhou Song, Wang Qiang, Gu Houyun, Fu Xiaoxing, Ding Yi, Zhang Bin, Dai Min
Department of Orthopedics, The First Affiliated Hospital of Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang, Jiangxi, 330006, China.
Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi, 330006, China.
BMC Musculoskelet Disord. 2016 Aug 15;17(1):341. doi: 10.1186/s12891-016-1193-6.
Sagittal spinopelvic alignment changes associated with degenerative facet joint arthritis have been assessed in a few studies. It has been documented that patients with facet joint degeneration have higher pelvic incidence, but the relationship between facet joint degeneration and other sagittal spinopelvic alignment parameters is still disputed. Our purpose was to evaluate the correlation between the features of sagittal spinopelvic alignment and facet joint degeneration.
Imaging data of 140 individuals were retrospectively analysed. Lumbar lordosis, pelvic tilt (PT), pelvic incidence (PI), sacral slope, and height of the lumbar intervertebral disc were measured on lumbar X-ray plates. Grades of facet joint degeneration were evaluated from the L2 to S1 on CT scans. Spearman's rank correlation coefficient and Student's t-test were used for statistical analyses, and a P-value <0.05 was considered statistically significant.
PI was positively associated with degeneration of the facet joint at lower lumbar levels (p < 0.001 r = 0.50 at L5/S1 and P = 0.002 r = 0.25 at L4/5). A significant increase of PT was found in the severe degeneration group compared with the mild degeneration group: 22.0° vs 15.7°, P = 0.034 at L2/3;21.4°vs 15.1°, P = 0.006 at L3/4; 21.0° vs 13.5°, P = 0.000 at L4/5; 20.8° vs 12.1°, P = 0.000 at L5/S1.
Our results indicate that a high PI is a predisposing factor for facet joint degeneration at the lower lumbar spine, and that severe facet joint degeneration may accompany with greater PT at lumbar spine.
少数研究评估了与退行性小关节关节炎相关的矢状位脊柱骨盆对线变化。有文献记载,小关节退变患者的骨盆倾斜度较高,但小关节退变与其他矢状位脊柱骨盆对线参数之间的关系仍存在争议。我们的目的是评估矢状位脊柱骨盆对线特征与小关节退变之间的相关性。
回顾性分析140例个体的影像学资料。在腰椎X线片上测量腰椎前凸、骨盆倾斜度(PT)、骨盆入射角(PI)、骶骨倾斜度和腰椎间盘高度。在CT扫描上评估L2至S1节段小关节退变的分级。采用Spearman等级相关系数和Student t检验进行统计分析,P值<0.05被认为具有统计学意义。
PI与下腰椎节段小关节退变呈正相关(p < 0.001,L5/S1节段r = 0.50;L4/5节段P = 0.002,r = 0.25)。与轻度退变组相比,重度退变组的PT显著增加:L2/3节段为22.0°对15.7°,P = 0.034;L3/4节段为21.4°对15.1°,P = 0.006;L4/5节段为21.0°对13.5°,P = 0.000;L5/S1节段为20.8°对12.1°,P = 0.000。
我们的结果表明,高PI是下腰椎小关节退变的一个易感因素,并且严重的小关节退变可能伴有腰椎更大的PT。