椎弓根角及椎小关节退行性变与腰椎椎体滑脱的相关性研究

目的 通过测量退行性腰椎滑脱(DS)的小关节有关数据,观察小关节面的改变,探讨引起退行性腰椎滑脱的可能局部因素.方法 应用64层螺旋CT对退行性L4～5腰椎滑脱的28例患者(滑脱组)与腰部疼痛但无腰椎滑脱的78例患者(对照组)的CT图像作小关节形态及其结构特点的对比分析.测量小关节椎弓根角、椎间小关节角角度,对所获的数据进行2组兼得参数t检验分析.结果 DS组L4～5矢状面椎弓根角平均值为左侧119.0°±2.2°、右侧118.8°±1.9°,对照组分别为左侧102.9°±1.2°、右侧104.7°±1.2°;滑脱组L4～5轴面小关节角平均值为左侧41.1°±1.2°、右侧29.0°±1.2°,对照组平均值分别为左侧45.5°±2.1°,右侧45.1°±1.2°.两组L4～5小关节椎弓根角、小关节夹角的差异均有统计学意义(P值均<0.05).结论 L4～5矢状面椎弓根角和轴面小关节角的改变对诊断退行性腰椎滑脱有重要意义.

Correlative study of vertebra arch angle, facet joint degeneration and lumbar spondylolisthesis

Objective The aim of this study was to analyze the mechanism of degenerative spondylolisthesis (DS) through measuring vertebra arch angle and facet joint degeneration with 64-slice spiral computed tomography (CT). Methods One hundred and six patients complained of lumbodynia were examined with 64-slice CT. In 28 of 106 patients have lumbar spondylolisthesis, while the other 78 cases have not. The vertebra arch angles of all cases were measured and the facet joint degenerations were analyzed. Results L4--5 vertebra arch angle in DS group were 119. 0°±2. 2°(left) and 118. 8°±1.9° (right) ,respectively. L4--5 vertebra arch angle in control group were 102.9°±1.2°(left) and 104. 7°± 1.2° (right) ,respectively. The joint angle in DS group were 41.1°±1.2°(left) ,and 29.0°±1.2°(right), respectively. The joint angle in control group were 45.5°±2. 1°(left), and 45. 1°±1.2°(right), respectively. There were significant differences of L4--5 vertebra arch angle and more serious of facet joint degeneration( P < 0. 05 ). Conclusion L4 vertebra arch inclination and facet joint degeneration were important to diagnosis of spondylolisthesis.