新战士100名强化训练前后腰椎椎弓峡部断裂情况调查

背景:新战士在新兵训练期间出现腰椎椎弓峡部断裂发病率较高并影响了正常训练。目的:分析部队新兵中腰椎椎弓峡部断裂的发病率与训练及其腰部原有病变的关系。设计:随机抽样调查。单位:解放军第九十七医院骨科。对象:某部2003年入伍的新兵100名,男性,平均年龄18.7岁。方法:对100名新兵全程追踪随访,于训练前及100d强化训练后分别摄腰部X射线正、侧位和双斜位片进行对照观察。主要观察指标:椎弓峡部断裂病例发病率,原有断裂者有无滑脱等加重现象。结果:调查对象100名均进入结果分析。①新兵训练前、后椎弓峡部断裂发病率:训练开始前的入伍新兵,L5椎弓峡部断裂5例,发病率为5%。100d训练结束时,腰椎椎弓峡部断裂8例,发病率增加至8%。②新兵训练前、后X射线检查结果:100名新战士X射线片训练开始前,左侧L5椎弓峡部变细2例,右侧L5椎弓峡部变细1例;双侧L5椎弓峡部断裂5例,其中1例呈I度滑脱。100d训练结束时,原双侧L5椎弓峡部断裂5例中I度以内滑脱3例,另3例原腰椎椎弓变细者均发生断裂。结论:腰椎椎弓峡部断裂发病率与训练强度有关。建议加强入伍新兵脊柱体检,常规加拍腰椎正、侧位和双斜位X射线片检查项目。

Investigation on spondylolysis of lumbar vertebral arch in 100 recruits before and after reinforced training

BACKGROUND: The incidence rate of spondylolysis of lumbar vertebral arch in recruits is higher during the training, and it affects the normal training. OBJECTIVE: To analyze the correlation of the incidence rate of spondy lolysis of lumbar vertebral arch with training and the original lesions at waist in recruits. DESIGN: A randomized sampling survey. SETTING: Department of Orthopaedics, the 97 Hospital of Chinese PLA. PARTICIPANTS: Totally 100 male recruits aged 18.7 years averagely en rolled in 2003 were involved in the survey. METHODS: The 100 recruits were followed up for the whole course, the X-ray examination at lumbar vertebrae of right, lateral and two-slope positions were observed before training and after 100-day reinforced training. MAIN OUTCOME MEASURES: The incidence rates of spondylolysis of vertebral arch, and whether there was slippage and other aggravations in those with spondylolysis before were mainly observed. RESULTS: All the 100 recruits entered the analysis of results. ① The in cidence rate of spondylolysis of vertebral arch before and after training: Be fore training, 5 cases had spondylolysis of L5 vertebral arch, and the incidence rate was 5%. At the end of the 100-day training, 8 cases had spondylolysis of lumbar vertebral arch, and the incidence rate increased to 8%. ② The results of X-ray examination before and after training: The Xray examination showed that isthmus narrowing of left and L5 vertebral arch occurred in 2 cases and 1 case respect ively, and spondylolysis of bilateral L5 vertebral arches occurred in 5 cases, including 1 case of degree I slip page before training. At the end of the 100-day training, the degree I slip page and below occurred in 3 of the 5 cases with spondylolysis of bilateral L5 vertebral arches before, another 3 cases with original narrowing of lumbar vertebral arch all had breakage. CONCLUSION: The incidence rate of spondylolysis of vertebral arch is associated with the training intensity. It suggestes that the examination of spinal cord should be reinforced in enrolled recruits, and the items of Xray examination at lumbar vertebrae of right, lateral and two-slope positions should be added.