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退变性腰椎侧凸患者冠状面失衡与退变椎间盘数量有关吗?一项回顾性影像学横断面研究。

Is coronal imbalance in degenerative lumbar scoliosis patients associated with the number of degenerated discs? A retrospective imaging cross-sectional study.

机构信息

Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China.

Department of Orthopaedic Surgery, China-Japan Friendship Hospital, 100029, Beijing, People's Republic of China.

出版信息

BMC Musculoskelet Disord. 2023 May 25;24(1):414. doi: 10.1186/s12891-023-06558-9.

Abstract

BACKGROUND

Degenerative lumbar scoliosis (DLS) is a common degenerative disease of the spine, that predominates in the elderly, and causes spinal deformities along with severe pain and reduced quality of life. The relationship between DLS and degenerated discs is now a new direction of research. Our study aimed to the relationship between the imaging parameters of coronal imbalance and the number of degenerated discs in patients with degenerative lumbar scoliosis and analyzed the segmental distribution of the degenerated discs in patients with DLS.

METHODS

We performed a retrospective analysis of the imaging of 40 patients who met the inclusion criteria who attended our outpatient clinic between April 2021 and July 2021, measuring the intervertebral space height of the AV (high side and low side), Cobb angle, and AVT (Apical vertebral translation) from coronal X-ray. Degenerated discs were evaluated by the Pfirrmann score based on T2-weighted magnetic resonance images. We record the number of degenerated discs (Graded as Grade III, Grade IV or Grade V by the Pfirrmann score) and the segments in which they are located. Finally, we explore the relationship between the imaging parameters of coronal imbalance and the number of degenerated discs in patients with DLS.

RESULT

Among the 40 patients with DLS in our study, all patients had degenerated discs in the lumbar spine, 95% of patients had degenerated discs(Pfirrmann score Grade III, Grade IV or Grade V) in 2 or more segments, with the L4-L5 segment being the most involved segment with the most degenerated discs, followed by the L3-L4 segment and the L5-S1 segment. There was no statistically significant relationship between the number of degenerated discs and the coronal imbalance in patients with DLS.

CONCLUSION

Our results showed an association between DLS and degenerated discs, but there was no statistically significant relationship between imbalance in the coronal plane of the lumbar spine and the number of degenerated discs in patients with DLS. The distribution of degenerated disc segments in patients with DLS showed a higher likelihood of disc degeneration in 2 or more segments, and a higher frequency of disc degeneration in the inferior disc and in the adjacent segments of the AV.

摘要

背景

退行性腰椎侧凸(DLS)是一种常见的脊柱退行性疾病,主要发生在老年人中,会导致脊柱畸形,同时伴有严重疼痛和生活质量下降。DLS 与退变椎间盘的关系是目前研究的一个新方向。本研究旨在探讨退行性腰椎侧凸患者冠状面失衡的影像学参数与退变椎间盘数量的关系,并分析 DLS 患者退变椎间盘的节段分布。

方法

我们对 2021 年 4 月至 2021 年 7 月期间在我院门诊就诊的符合纳入标准的 40 例患者的影像学资料进行回顾性分析,从冠状位 X 线片上测量 AV(高侧和低侧)的椎间高度、Cobb 角和 AVT(顶椎平移)。退变椎间盘根据 T2 加权磁共振图像的 Pfirrmann 评分进行评估。我们记录退变椎间盘的数量(按 Pfirrmann 评分分为 3 级、4 级或 5 级)及其所在节段。最后,我们探讨了 DLS 患者冠状面失衡的影像学参数与退变椎间盘数量的关系。

结果

在我们的研究中,40 例 DLS 患者均存在腰椎间盘退变,95%的患者 2 个或以上节段存在退变椎间盘(Pfirrmann 评分 3 级、4 级或 5 级),最常受累的节段是 L4-L5 节段,其次是 L3-L4 节段和 L5-S1 节段。DLS 患者的退变椎间盘数量与冠状面失衡之间无统计学显著相关性。

结论

我们的结果表明 DLS 与退变椎间盘之间存在关联,但 DLS 患者腰椎冠状面失衡与退变椎间盘数量之间无统计学显著相关性。DLS 患者退变椎间盘节段分布显示 2 个或以上节段发生椎间盘退变的可能性更高,下位椎间盘和 AV 相邻节段的椎间盘退变频率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/968a/10210366/35423cb50256/12891_2023_6558_Fig1_HTML.jpg

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