MRI测量腰椎关节突角度在早期诊断椎间盘突出的应用价值

目的探讨MRI测量腰椎关节突角度在早期诊断腰椎间盘突出症中的应用价值。方法将我院收治的97例L4-5腰椎间盘突出的患者作为观察组,均进行MRI检查,并根据其椎间盘突出类型分为中央型、旁侧型,例数分别为41例、56例。选择同期于我院进行体检的腰椎MRI显示无腰椎间盘突出症的35例健康人作为对照组,MRI测量观察组和对照组L4-5节段左关节突角度值(α)和右关节突关节角度值(β),最终角度值为两侧关节突关节角度值平均值,关节突夹角差值γ=|α-β|,关节突关节不对称判断标准为γ≥10°,比较两组L4-5节段α、β、γ值和关节突关节不对称发生情况,以及不同分型L4-5节段α、β、γ值和关节突关节不对称发生情况。结果观察组α值大于对照组(P<0.05),β值小于对照组(P<0.05),γ值大于对照组(P<0.05),关节突关节不对称发生率大于对照组(P<0.05);旁侧型α值大于中央型(P<0.05),β值与中央型无显著差异(P<0.05),γ值及关节突关节不对称发生率均大于中央型(P<0.05)。结论 MRI测量腰椎关节突角度对腰椎间盘突出症早期诊断具有指导作用,可作为腰椎间盘突出症预防和康复重要指标。

Application Value of Measuring Lumbar Facet Joint Orientation by MRI in Early Diagnosis of Lumbar Disc Herniation

Objective To investigate the application value of measuring lumbar facet joint orientation by MRI in early diagnosis of lumbar disc herniation. Methods 97 patients with L4-5 lumbar disc herniation admitted to the hospital were enrolled as the observation group, All undergoing MRI examination. According to the types of lumbar disc herniation, they were divided into central type and lateral type, with 41 cases and 56 cases, respectively. 35 healthy people without lumbar disc herniation showed by lumbar MRI who underwent physical examination during the same period in the hospital was enrolled as the control group. MRI was performed to measure left facet joint orientation values(α) and right facet joint orientation values(β) of L4-5 segment in the observation group and the control group. The final orientation value was the average value of the bilateral facet joint orientations. the difference value of the facet joint γ equaled to |α-β|. Taking γ≥10° as the criterion of asymmetry of the facet joint. The α, β and γ values of the L4-5 segment and the asymmetry of the facet joints were compared between the two groups, as well as the above indexes in patients with different types. Results The α of the observation group was greater than that of the control group(P<0.05), while β was smaller than that of the control group(P<0.05). And the γ was greater than that of the control group(P<0.05). The incidence of asymmetry of the facet joint was greater than that of the control group(P<0.05). The α of lateral type was greater than that of central type(P<0.05). There was no significant difference in the β between the two types(P<0.05). The γ and incidence of asymmetry of the facet joint of lateral type were greater than those the central type(P<0.05). Conclusion Measuring lumbar facet joint orientation by MRI has a guiding role for the early diagnosis of lumbar disc herniation, which can be used as an important indicator for the prevention and rehabilitation of lumbar disc herniation.