腰椎间盘突出症突出物自然吸收与腰椎曲度的相关性研究

目的研究腰椎间盘突出症组织不同程度自然吸收与腰椎曲度的相关性。方法回顾分析上海市宝山区仁和医院2015年1月至2019年6月CT检查确诊腰椎间盘突出症病人61例，均为保守治疗，并具有6~24个月随访复查资料。根据突出物自然吸收程度分为明显重吸收组(10例)，部分重吸收组(8例)，基本不变组(30例)，增大组(13例)四组，配对比较每组腰椎曲线指数、腰椎前凸角变化，并进行相关分析。结果腰椎间盘突出症明显重吸收组、部分重吸收组、基本不变组、增大组的首次CT检查腰椎曲线指数、腰椎前凸角比较，差异无统计学意义(P>0.05)；经治疗后随访CT腰椎曲线指数［10.65(9.23，13.31)mm 比11.69(8.31，15.25)mm 比8.63(6.75，11.00)mm 比8.06(5.00，10.05)mm］、腰椎前凸角［46.30(43.96，48.18)°比45.36(44.15，47.67)°比39.37(32.27，45.74)°比35.39(29.60，43.16)°］比较，差异有统计学意义(P<0.05)。明显吸收组、部分重吸收组随访腰椎曲线指数、腰椎前凸角较首次CT检查增大(P<0.05)；增大组随访腰椎曲线指数、腰椎前凸角较首次CT检查减小(P<0.05)；基本不变组腰椎曲线指数、腰椎前凸角前后配对比较差异无统计学意义(P>0.05)。腰椎间盘突出症自然吸收程度与腰椎曲线指数、腰椎前凸角变化均呈正相关(rs=0.50、0.47，P<0.05)。结论腰椎曲线指数及腰椎前凸角随着腰椎突出椎间盘自然吸收而增大，当腰椎突出椎间盘增大时腰椎曲线指数及腰椎前凸角也相应减小。腰椎间盘突出症组织自然吸收程度与腰椎曲度变化呈正相关。

Research on correlation between spontaneous absorption of herniated intervertebral discs and lumbar curvature

Objective To study the correlation between the different degree of natural absorption of the lumbar disc herniation and the lumbar curvature.Methods Sixty-one patients with lumbar disc herniation diagnosed by CT scan in Renhe Hospital of Baoshan District, Shanghai from January 2015 to June 2019 were retrospectively analyzed. All patients were treated conservatively and followed up for 6-24 months. According to the degree of protrusion absorption, they were assigned into four groups: obvious reabsorption group (n=10) , partial reabsorption group (n=8) , basically unchanged group (n=30) and enlarged group (n=13). The lumbar curve index and the changes of lumbar lordosis angle in each group were compared and the correlation analysis was performed.Results There was no significant difference in curve index and lumbar lordosis angle between obvious reabsorption group, partial reabsorption group, basically unchanged group and enlarged group (P>0.05). After treatment, the curve index 10.65 (9.23, 13.31) mm vs. 11.69 (8.31, 15.25) mm vs.8.63 (6.75, 11.00) mm vs. 8.06 (5.00, 10.05) mm] and lumbar lordosis angle 46.30 (43.96, 48.18)° vs. 45.36 (44.15, 47.67)° vs. 39.37(32.27, 45.74)° vs. 35.39 (29.60, 43.16)°] were compared, the difference was significant (P<0.05). The curve index and lordosis angle of the lumbar spine in the obvious absorption group and the partial reabsorption group were significantly higher than those in the first CT examination (P<0.05), and the curve index and lordosis angle of the lumbar spine in the enlargement group were significantly lower than those in the first CT examination (P<0.05), and the curve index and lordosis angle of the lumbar spine in the basically unchanged group was no significant difference (P>0.05). There was a positive correlation between the degree of lumbar disc herniation natural absorption and Lumbar curve index (rs=0.50, P<0.05), and a positive correlation between the degree of lumbar disc herniation natural absorption and the change of lumbar lordosis angle (rs=0.47, P<0.05).Conclusions The curve index and lordosis angle of the lumbar spine increase with the natural absorption of lumbar herniated intervertebral disc. When the lumbar herniated intervertebral disc increases,the curve index and lordosis angle of the lumbar spine also decrease accordingly. The degree of natural absorption of lumbar disc herniation was positively correlated with the change of lumbar curvature.