摘要
目的探讨腰椎骨性结构的异常是否为退行性腰椎滑脱的病因,及退行性改变在退行性腰椎滑脱发病中的意义。方法随机选取退行性腰椎滑脱患者40例(病例组),男10例,女30例;平均年龄(61.35±9.91)岁;非退行性腰椎滑脱患者56例(对照组),男13例,女43例;平均年龄(57.27±10.00)岁。两组患者均划分为三个年龄段:45～54岁,55～65,≥66岁。在X线侧位片和腰椎CT或横断面MRI片上测量骶骨相对矢状旋转角、L5椎体相对倾斜角、腰椎前凸角、腰骶角、椎弓根下关节突角、小关节突面冠状位角,并对两组结果进行比较。结果各年龄段和总体的L5椎体相对倾斜角、骶骨相对矢状旋转角、腰骶角、腰椎前凸角、腰椎前凸系数、椎弓根下关节突角病例组与对照组比较差异无显著性(P>0.05);病例组与对照组的左侧及右侧小关节突面冠状位角之间的差异有显著性(P<0.01)。结论骨性结构的异常不是退行性腰椎滑脱的发病原因。
Objective The etiology of degenerative spondylolisthesis was not defined and deserved further exploration. The study was to investigate whether abnormalities of lumbar bony structure could lead to degenerative spondylolisthesis and to evaluate the importance of degeneration in degenerative spondylolisthesis. Methods The degenerative spondylolisthesis group consisted of 40 patients whose average age was (61.35±9.91) years, there were 10 males and 30 females diagnosed as L4 spondylolisthesis; while the non degenerative spondylolisthesis group consisted of 56 patients whose average age was (57.27±10.00) years, there were 13 males and 43 females. Bony construction parameters including relative inclination of L5, relative sacral sagittal rotating angle, lumbosacral angle, lumbar lordotic angle, lumbar lordotic index, pedical-facet angle and coronal inclination of the facet joint were measured on lateral view roentgenograms and CT or MR imaging. The difference of the calculated angles between degenerative spondylolisthesis and non degenerative spondylolisthesis groups were analysed statistically. Results In terms of the degrees of relative inclinations of L5, relative sacral sagittal rotating angles, lumbosacral angles, lumbar lordotic angles, lumbar lordotic indexes, pedical-facet angles, there was no significant difference between degenerative spondylolisthesis and non degenerative spondylolisthesis groups (P > 0.05). The mean degrees for coronal inclinations of facet joint of the patients with degenerative spondylolisthesis were significantly greater than those of the patients without degenerative spondylolisthesis (P < 0.01). Conclusion The abnormalities of lumbar bony structure parameters including the relative inclination of L5, relative sacral sagittal rotating angle, lumbosacral angle, lumbar lordotic angle, lumbar lordotic index and pedical-facet angle exert no risk on the pathogenesis of degenerative spondylolisthesis. The change of coronal inclination of the facet joints is the result of remodeling acco
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2003年第9期518-522,共5页
Chinese Journal of Orthopaedics
