腰骶椎矢状位形态学改变与椎间盘退变的MRI评价

背景：目前关于椎间盘退变在MRI上的影像学表现及其与下腰痛的关系报道甚多,但腰骶椎矢状位形态学改变与椎间盘退变程度的关系国内尚未见相关报道。目的：观察下腰痛患者腰骶椎矢状位形态学改变与椎间盘退变的关系,并探讨其临床意义。方法：对主诉下腰痛来安徽医科大学第一附属医院门诊就诊并行MRI检查的患者做回顾性分析,选择年龄20～30岁的女性患者167例,在MRI正中矢状面的T2W1图像上观察椎间盘的信号改变及退变程度,评价退变分级,测量每个患者的腰椎前凸角,骶骨平台角及骶椎后凸角度。结果与结论：椎间盘退变组与无椎间退变组腰椎前凸角分别为（24.31±3.48）°和（26.29±3.74）°,差异有显著性意义（P=0.001）;骶骨平台角分别为（102.97±5.58）°和（100.70±3.26）°,差异有显著性意义（P=0.002）;骶骨后凸角分别为（163.45±7.03）°和（167.24±6.71）°,差异有显著性意义（P=0.001）。提示腰椎前凸角、骶骨后凸角、骶骨平台角是评价椎间盘退变程度的形态学参数,腰椎前凸角和骶骨后凸角随椎间盘退变加重而减小,骶骨平台角随椎间盘退变加重而增大。

Magnetic resonance imaging evaluation of the relationship between the lumbosacral spine saggital morphology and intervertebral disc degeneration

BACKGROUND：Now,there are a large number of articles related to performance of intervertebral disc degeneration in magnetic resonance imaging（MRI） and the relationship between the intervertebral disc degeneration and low back pain.Nonetheless,there are few publications reporting the relationship between the degree of intervertebral disc degeneration and the lumbosacral morphology.OBJECTIVE：To investigate the clinical significance and relationship between the lumbosacral saggital morphology and intervertebral disc degeneration.METHODS：MRI of outpatients who went to First Affiliated Hospital of Anhui Medical University because of low back pain were retrospectively studied.167 female patients aged 20 to 30 years old were selected.The presence and degree of intervertebral disc degeneration were evaluated on saggital T2W1 weighted MRI passing through the midsagittal line,angles of lumbar lordosis,sacral table and sacral kyphosis were also measured on the same image.RESULTS AND CONCLUSION：There were statistically significant differences about the angles of lumbar lordosis（24.31±3.48）°,（26.29±3.74）°,sacral table（102.97±5.58）°,（100.70±3.26）°,and sacral kyphosis（163.45±7.03）°,（167.24±6.71）° respectively in intervertebral disc degeneration group and without intervertebral disc degeneration group（P=0.001,P =0.002,P =0.001,respectively）.The sacral kyphosis and lumbar lordosis angles decrease with the increasing of the degree of intervertebral disc degeneration,and the sacral table angle increases in parallel to the increase of the degree of intervertebral disc degeneration.The sacral kyphosis,lumbar lordosis angle and sacral table angle are the morphological parameters for intervertebral disc degeneration evaluation.