Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China; Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Liaoning Province, People's Republic of China; Department of Orthopaedics, The Second Hospital of Tangshan, Tangshan, People's Republic of China.
Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China; Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Liaoning Province, People's Republic of China.
J Clin Neurosci. 2023 Mar;109:50-56. doi: 10.1016/j.jocn.2023.01.013. Epub 2023 Jan 31.
We aimed to determine whether there is an association, in young adults, between the occurrence of lumbar disk herniation (LDH) at a given segment and the segment's facet joint parameters [facet orientation (FO) and tropism (FT)]. In addition, associations between facet joint parameters in the corresponding segment and LDH laterality were also investigated.
We retrospectively analyzed data from 529 patients who were between 18 and 35 years old, who had experienced single-level LDH (L4-5 or L5-S1) between June 2017 and December 2019, and with<2 years of clinical history. We included an additional 122 patients with no history of LDH as an age-matched control group. LDH were classified by laterality (left-sided, right-sided, or central herniation). At each level, we investigated the relationship between facet joint parameters and herniation laterality.
FO values at the L4-L5 level and the L5-S1 level were significantly lower and FT was higher for the LDH group compared with those for the control group. The level at which LDH occurred, FO, FO, and FT differed significantly among the three groups. There was a significant association between herniationlaterality and FO at the L4-L5 level but not at the L5-S1 level.
Abnormal facet joint parameters are significantly associated with LDH. Young adults with higher FT should be paid more attention, to prevent the occurrence of LDH. Compared with L5-S1 level, intervertebral disk herniation at the L4-L5 level tended to occur ipsilateral to the side with a lower facet joint angle when FT was present.
本研究旨在确定年轻人中特定节段腰椎间盘突出症（LDH）的发生与该节段关节突关节参数[关节突方位（FO）和倾斜度（FT）]之间是否存在关联。此外，还研究了相应节段关节突关节参数与 LDH 侧别之间的相关性。
我们回顾性分析了 2017 年 6 月至 2019 年 12 月期间经历单节段 LDH（L4-5 或 L5-S1）且临床病史<2 年的 529 例年龄在 18 至 35 岁之间的患者的数据。另外还纳入了 122 例无 LDH 病史的年龄匹配对照组患者。LDH 根据侧别（左侧、右侧或中央型突出）进行分类。在每个节段，我们研究了关节突关节参数与突出侧别之间的关系。
与对照组相比，LDH 组 L4-L5 水平和 L5-S1 水平的 FO 值显著降低，FT 值更高。三个组之间发生 LDH 的水平、FO、FO 和 FT 差异均有统计学意义。LDH 的发生部位、FO、FO 和 FT 与侧别之间存在显著相关性。在 L4-L5 水平，与 FO 之间存在显著相关性，但在 L5-S1 水平则无相关性。
关节突关节参数异常与 LDH 有显著相关性。应更加关注 FT 值较高的年轻人，以预防 LDH 的发生。与 L5-S1 水平相比，当 FT 值较高时，L4-L5 水平的椎间盘突出更倾向于发生在 FT 值较低的节段同侧。
