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通过对腰椎滑脱症患者椎间盘的研究对脊柱疾病的再思考和再探讨。

Reconsideration and Reflection on Spinal Disorders Through the Study of Intervertebral Discs in Patients with Lumbar Spondylolisthesis.

机构信息

The Spinal Surgery Department of the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China; Hebei Medical University, Shijiazhuang, Hebei, China.

The Spinal Surgery Department of the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.

出版信息

World Neurosurg. 2024 Aug;188:e326-e333. doi: 10.1016/j.wneu.2024.05.108. Epub 2024 May 23.

Abstract

OBJECTIVE

This study analyzed and explored the relationship between isthmic spondylolisthesis and disc degeneration by comparing the degree of disc degeneration in patients with isthmic spondylolisthesis, lumbar disc herniation, and asymptomatic healthy individuals.

METHODS

This study included a total of 138 cases, consisting of L5-S1 single segment lesion patients and a normal lumbar spine population. The cases were divided into 3 groups based on the type of disease: fifty eight cases in the isthmic spondylolisthesis (IS) group, 50 cases in the lumbar disc herniation (LDH) group, and 30 cases in the normal lumbar vertebrae (NLV) group.

RESULTS

The research findings indicate that the proportion of intervertebral disc degeneration in the LDH group is significantly higher than that in the IS group and NLV group (65.3% vs. 33.3% vs. 25.8%, P < 0.05). The Pfirrmann grades of lumbar intervertebral discs (L1-L4) in the LDH group are significantly higher than those in the IS group and NLV group (P < 0.05), and the intervertebral height index (IHI) (L1-L4) of lumbar vertebrae in the LDH group is significantly lower than that in the IS group and NLV group (P < 0.05).

CONCLUSIONS

The results showed that the degree of intervertebral disc degeneration in patients with isthmic spondylolisthesis was lighter than that in patients with LDH, and even similar to that in healthy individuals. The occurrence of IS may have slowed down the degeneration of nonaffected segment intervertebral discs through certain factors.

摘要

目的

本研究通过比较峡部裂性滑脱、腰椎间盘突出症和无症状健康人群椎间盘退变程度,分析探讨峡部裂性滑脱与椎间盘退变的关系。

方法

本研究共纳入 138 例患者,均为 L5-S1 单节段病变患者和正常腰椎人群。根据疾病类型将病例分为 3 组:峡部裂性滑脱(IS)组 58 例,腰椎间盘突出症(LDH)组 50 例,正常腰椎(NLV)组 30 例。

结果

研究结果表明,LDH 组椎间盘退变比例明显高于 IS 组和 NLV 组(65.3%比 33.3%比 25.8%,P<0.05)。LDH 组腰椎间盘(L1-L4)的 Pfirrmann 分级明显高于 IS 组和 NLV 组(P<0.05),LDH 组腰椎椎间高度指数(L1-L4)明显低于 IS 组和 NLV 组(P<0.05)。

结论

结果表明,IS 患者的椎间盘退变程度较 LDH 患者轻,甚至与健康人群相似。IS 的发生可能通过某些因素减缓了非受累节段椎间盘的退变。

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