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一项体内研究探讨了腰椎早期到中期椎间盘退变与屈伸活动度之间的相关性。

An in vivo study exploring correlations between early-to-moderate disc degeneration and flexion mobility in the lumbar spine.

机构信息

Faculty of Science and Technology, Bournemouth University, Poole, BH12 5BB, UK.

Centre for Biomechanics Research, AECC University College, Parkwood Campus, Bournemouth, BH5 2DF, UK.

出版信息

Eur Spine J. 2020 Oct;29(10):2619-2627. doi: 10.1007/s00586-020-06526-0. Epub 2020 Jul 10.

Abstract

PURPOSE

Early disc degeneration (DD) has been thought to be associated with loss of spine stability. However, before this can be understood in relation to back pain, it is necessary to know the relationship between DD and intervertebral motion in people without pain. This study aimed to find out if early-to-moderate DD is associated with intervertebral motion in people without back pain.

METHODS

Ten pain-free adults, aged 51-71, received recumbent and weight bearing MRI scans and quantitative fluoroscopy (QF) screenings during recumbent and upright lumbar flexion. Forty individual level and 10 composite (L2-S1) radiographic and MRI DD gradings were recorded and correlated with intervertebral flexion ROM, translation, laxity and motion sharing inequality and variability for both positions.

RESULTS

Kinematic values were similar to previous control studies. DD was evidenced up to moderate levels by both radiographic and MRI grading. Disc height loss correlated slightly, but negatively with flexion during weight bearing flexion (R =  - 0.356, p = 0.0.025). Composite MRI DD and T2 signal loss evidenced similar relationships (R =  - 0.305, R =  - 0.267) but did not reach statistical significance (p = 0.056, p = 0.096). No significant relationships between any other kinematic variables and DD were found.

CONCLUSION

This study found only small, indefinite associations between early-to-moderate DD and intervertebral motion in healthy controls. Motion sharing in the absence of pain was also not related to early DD, consistent with previous control studies. Further research is needed to investigate these relationships in patients.

摘要

目的

早期椎间盘退变(DD)被认为与脊柱稳定性丧失有关。然而,要了解 DD 与背痛的关系,就必须首先知道无症状人群中 DD 与椎间运动的关系。本研究旨在确定无腰痛的人群中早期到中度 DD 是否与椎间运动有关。

方法

10 名无痛的成年人,年龄在 51-71 岁之间,在卧位和负重位下接受 MRI 扫描和定量荧光透视(QF)筛查,并在卧位和直立位腰椎前屈时进行。记录 40 个个体节段和 10 个复合(L2-S1)放射学和 MRI DD 分级,并与两个位置的椎间前屈 ROM、平移、松弛和运动分配不平等和变异性相关联。

结果

运动学值与以前的对照研究相似。放射学和 MRI 分级均证实 DD 达到中度水平。椎间盘高度损失与负重前屈时的前屈(R = -0.356,p = 0.025)有轻微但负相关。复合 MRI DD 和 T2 信号丢失表现出相似的关系(R = -0.305,R = -0.267),但未达到统计学意义(p = 0.056,p = 0.096)。没有发现任何其他运动学变量与 DD 之间有显著关系。

结论

本研究仅发现早期到中度 DD 与健康对照组椎间运动之间存在微小的、不确定的关联。在无疼痛的情况下,运动分配也与早期 DD 无关,这与以前的对照研究一致。需要进一步研究以调查这些在患者中的关系。

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