Miyake R, Ikata T, Katoh S, Morita T
Department of Orthopedic Surgery, School of Medicine, University of Tokushima, Japan.
Spine (Phila Pa 1976). 1996 Apr 1;21(7):783-9. doi: 10.1097/00007632-199604010-00001.
Morphological analysis was performed of the facet joint of the normal and spondylolytic lumbosacral spine in children and adolescents.
This study was performed to estimate the influence of spondylolysis on growth of the neural arch of the lumbosacral spine.
The development of the facet joint and its relation to spondylolysis have not been documented in the literature.
The dimension and orientation of the facet joint at L5/S were measured on radiographs and computed tomography scans from 144 boys without pars defects and 104 boys with pars defects. The latter group was further investigated according to the stage of pars defects. Patients in both groups were between 9 and 18 years of age.
Growth of the facet joint in the sagittal and transverse directions and the increase of the transverse angle were remarkable up to approximately 13 years of age. Concavity of the facet joints also progressed in children of the same age. The growth of the facet joint in patients with spondylolysis was significantly retarded as the pars defects advanced from the progressive to the terminal stage. The joint surface was more coronal in orientation and flatter in shape compared with controls.
The present results suggest that pars defects occurring in children disturb or retard the growth of the facet joint and that the morphological characteristics of the joint surfaces in patients with spondylolysis are the consequence of these defects.
对儿童和青少年正常及椎弓根峡部裂性腰骶椎的小关节进行形态学分析。
本研究旨在评估椎弓根峡部裂对腰骶椎神经弓生长的影响。
文献中尚未记载小关节的发育及其与椎弓根峡部裂的关系。
对144名无椎弓根峡部裂缺陷的男孩和104名有椎弓根峡部裂缺陷的男孩的腰椎X线片和计算机断层扫描图像测量L5/S小关节的尺寸和方向。后一组根据椎弓根峡部裂缺陷的阶段进一步研究。两组患者年龄均在9至18岁之间。
小关节在矢状面和横断面上的生长以及横角的增加在大约13岁之前都很显著。同龄儿童小关节的凹陷也在进展。随着椎弓根峡部裂缺陷从进行期发展到终末期，患有椎弓根峡部裂的患者小关节的生长明显迟缓。与对照组相比，关节面的方向更呈冠状位，形状更扁平。
目前的结果表明，儿童期出现的椎弓根峡部裂缺陷会干扰或延缓小关节的生长，并且椎弓根峡部裂患者关节面的形态特征是这些缺陷的结果。
