不同滑脱程度退变性腰椎滑脱椎间盘形态改变及意义

目的:观察不同滑脱程度的退变性腰椎滑脱的椎间盘影像学特点,探讨椎间盘退变程度、椎间隙角度及椎间隙高度与不同程度退变性腰椎滑脱的关系.方法:回顾性分析了2009年10月至2011年11月北京市石景山医院和北京大学第三医院L4/5退变性腰椎滑脱患者51例,Ⅰ度退变性腰椎滑脱35例为试验1组,Ⅱ度退变性腰椎滑脱16例为试验2组；对L4/5椎间盘退变程度按照Pfirrmann法分级,CT测定L4/5椎间盘正中矢状面的椎间隙角度和椎间隙高度,对所得数据进行统计学分析.结果:实验1组L4/5椎间盘MRI退变程度B、C、D、E级分别为0、23、11及1例,试验2组分别为2、10、3及1例,两组椎间盘退变程度间差异无统计学意义(P＞0.05)；CT测量L4/5椎间隙角度实验1组和试验2组分别为(3.49±1.91)°和(2.14±1.38)°,实验1组椎间隙角度明显大于实验2组(P＜0.05)；椎间隙高度实验1组和试验2组分别为(8.57±1.80) mm和(7.40±1.54)mm,两组间比较差异有统计学意义(P＜0.05).结论:椎间隙角度减小和椎间隙高度丢失严重程度,可能是导致退变性腰椎滑脱出现不同滑脱程度的重要因素之一.

Study on the effectivity of lumbar disc degeneration in different degree degenerative lumbar spondylolisthesis and its significance

Objective: To study the pathogenesy of different degree degenerative lumbar spondylolisthesis(LDS) through investigating the degrees of intervertebral disc degeneration and the intervertebral space angles and intervertebral space heights.Methods: Fifty-one cases of L4/5 LDS were collected from Beijing Shijingshan Hospital and Peking University 3rd Hospital were reviewed and analysed from 2009/10 to 2011/11.Thirty-five cases of Ⅰ degree LDS were the first experimental group and 16 cases of Ⅱ degree LDS were the second experimental group.The L4/5 parameters of T2 weighted MRI and CT in two groups were collected.The degree of L4/5 intervertebral disc degeneration was classified by using modified Pfirrmann scale.The angles and the heights of L4/5 intervertebral space were surveyed and evaluated through the pictures of CT.The levels of L4/5 degeneration discs and the angles and the heights of L4/5 intervertebral space were compared between the two groups.Results: The parameters of the levels of L4/5 degenerative intervertebral disc were 0,23,11 and 1 cases in B,C,D and E level in the first experimental group.Others were 2 and 10 and 3 and 1 cases in B and C and D and E level in the second experimental group.The L4/5 intervertebral space angles were(3.49±1.91)° in the first experimental group and(2.14±1.38)° in the second experimental group.The L4/5 intervertebral space heights were(8.57±1.80)mm in the first experimental group and(7.40±1.54)mm in the second experimental group.The parameters of the L4/5 intervertebral space heights and intervertebral space angles had statistic significances(P<0.05)between two groups.Conclusion: The intervertebral space angles and intervertebral space heights which diminished are possibly an important factor to create different degree LDS.