关节突关节不对称与腰椎退行性疾病的相关性：一项回顾性分析
Correlation between facet tropism and lumbar degenerative disease: a retrospective analysis.
作者信息
Gao Tian, Lai Qi, Zhou Song, Liu Xuqiang, Liu Yuan, Zhan Ping, Yu Xiaolong, Xiao Jun, Dai Min, Zhang Bin
机构信息
Department of Orthopedics, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital of Nanchang University, 17 Yongwai Street, Nanchang, 330006, Jiangxi, People's Republic of China.
出版信息
BMC Musculoskelet Disord. 2017 Nov 22;18(1):483. doi: 10.1186/s12891-017-1849-x.
BACKGROUND
The aim of this study was to investigate the correlation between facet tropism and spinal degenerative diseases, such as degenerative lumbar spondylolisthesis, degenerative lumbar scoliosis, and lumbar disc herniation.
METHODS
This study retrospectively analysed clinical data from the Department of Orthopaedics at The First Affiliated Hospital of Nanchang University. Ninety-two patients were diagnosed with lumbar spondylolisthesis, 64 patients with degenerative scoliosis, and 86 patients with lumbar disc herniation between 1 October 2014 and 1 October 2016. All patients were diagnosed using 3.0 T magnetic resonance imaging and underwent conservative or operative treatment. Facet tropism was defined as greater than a ten degree between the facet joint angles on both sides.
RESULTS
For L3-L4 degenerative lumbar spondylolisthesis, one out of six cases had tropism compared to seven out of the 86 controls (p = 0.474). At the L4-L5 level, 17/50 cases had tropism compared to 4/42 cases in the control group (p = 0.013). At the L5-S1 level, 18/36 cases had tropism compared to 7/56 controls (p = 0.000). For degenerative lumbar scoliosis at the L1-L5 level, 83/256 cases had tropism as compared to 36/256 controls (p = 0.000). For L3-L4 lumbar disc herniation two out of eight cases had tropism compared to 14/78 controls (p = 0.625). At the L4-L5 level, 19/44 cases had tropism compared to four out of 42 controls (p = 0.001). At the L5-S1 level, 24/34 cases had tropism compared to 10/52 controls (p = 0.000).
CONCLUSION
At the L4-5 and L5-S1 levels, facet tropism is associated with degenerative spondylolisthesis. In the degenerative lumbar scoliosis group, the number of case with facet tropism was significantly higher than that of the control group. Facet tropism was associated with lumbar disc herniation at the L4-5 and L5-S1 levels. Overall, in these three lumbar degenerative diseases, facet tropism is a common phenomenon.
背景
本研究旨在探讨小关节不对称与脊柱退行性疾病之间的相关性，这些疾病包括退行性腰椎滑脱、退行性腰椎侧弯和腰椎间盘突出症。
方法
本研究回顾性分析了南昌大学第一附属医院骨科的临床资料。2014年10月1日至2016年10月1日期间，92例患者被诊断为腰椎滑脱，64例患者被诊断为退行性侧弯，86例患者被诊断为腰椎间盘突出症。所有患者均采用3.0T磁共振成像进行诊断，并接受了保守或手术治疗。小关节不对称定义为两侧小关节角度相差大于10度。
结果
对于L3-L4节段的退行性腰椎滑脱，6例中有1例存在小关节不对称，而86例对照组中有7例存在小关节不对称（p = 0.474）。在L4-L5节段，50例中有17例存在小关节不对称，而对照组42例中有4例存在小关节不对称（p = 0.013）。在L5-S1节段，36例中有18例存在小关节不对称，而对照组56例中有7例存在小关节不对称（p = 0.000）。对于L1-L5节段的退行性腰椎侧弯，256例中有83例存在小关节不对称，而对照组256例中有36例存在小关节不对称（p = 0.000）。对于L3-L4节段的腰椎间盘突出症，8例中有2例存在小关节不对称，而对照组78例中有14例存在小关节不对称（p = 0.625）。在L4-L5节段，44例中有19例存在小关节不对称，而对照组42例中有4例存在小关节不对称（p = 0.001）。在L5-S1节段，34例中有24例存在小关节不对称，而对照组52例中有10例存在小关节不对称（p = 0.000）。
结论
在L4-5和L5-S1节段，小关节不对称与退行性腰椎滑脱相关。在退行性腰椎侧弯组中，存在小关节不对称的病例数明显高于对照组。小关节不对称与L4-5和L5-S1节段的腰椎间盘突出症相关。总体而言，在这三种腰椎退行性疾病中,小关节不对称是一种常见现象。
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