摘要
目的分析椎间盘退变合并椎周软组织损伤的MRI特点,观察椎间盘退变合并椎周软组织损伤类型。方法回顾性分析自2019-10—2019-06行MRI检查的225例资料,186例确诊为腰椎间盘退变(观察组),39例为腰椎正常者(对照组)。记录观察组椎间盘退变情况,比较观察组与对照组椎周软组织损伤分布情况。结果观察组共发现411个椎间盘中退变,其中单节段退变39例,2个节段退变57例,3个节段退变86例。L3、4椎间盘退变117个,L4、5椎间盘退变165个,L5S1椎间盘退变129个,退变按Pfirrman分级:Ⅱ级30个,Ⅲ级111个,Ⅳ级228个,Ⅴ级42个。165例Ⅳ级与Ⅴ级椎间盘退变均合并至少2种以上软组织损伤,损伤总数534个;而21例Ⅱ级与Ⅲ级退变未发现同时合并2种以上软组织损伤,损伤总数24。观察组558个椎周软组织损伤,损伤具体分布在肌筋膜(T12~S2)、棘上韧带(L1~5)、棘间韧带(L2~S1)、竖脊肌(L3~S2)、多裂肌(L3~S2)、小关节囊(L3~S1)、黄韧带(L3~5)。对照组出现33处椎周软组织损伤,损伤分布在棘上韧带(L4~5)、棘间韧带(L3~5)、竖脊肌(L1~5)、多裂肌(L3~5)、小关节囊(L3~4),观察组椎周各种软组织损伤数明显高于对照组,差异有统计学意义(P<0.05)。结论椎间盘退变合并椎周软组织损伤率高,且椎间盘退变等级越高合并椎周软组织损伤率也随之增高。
Objective To analyze the MRI characteristics of lumbar intervertebral disc degeneration(IVD)combined with perivertebral soft tissue injury and observe the types of injury.Methods A retrospective analysis of 225 patients undergoing MRI for the lumbar from June 2019 to October 2019 was performed.Among these patients,186 were diagnosed as IVD(observation group)and 39 as normal lumbar vertebrae(control group).The status of IVD in the observation group was recorded.And the distribution and situation of soft tissue injury around the vertebra were compared between the observation group and the control group.Results A total of 411 IVD were found in the observation group,including 39 single segmental degeneration,572-segmental degeneration and 863-segmental degeneration.Among the IVD,117 located at the L3/L4 intervertebral disc,165 at the L4/L5 and 129 at the L5/S1.The IVD were classified by Pfirrman grading system,30 of levelⅡ,111 levelⅢ,228 levelⅣand 42 levelⅤ;165 cases of both levelⅣandⅤIVD had at least 2 kinds of soft tissue injuries and the injury number was 534;21 cases ofⅡandⅢdegeneration were found with a minimum of 2 kinds of soft tissue injuries with a sum of 24.In the total number of 558 perivertebral soft tissue injuries of the observation group,they were specifically distributed in myofascia(T12-S2),supraspinous ligament(L1-5),interspinous ligament(L2-S1),erector spinous muscle(L3-S2),multifissure(L3-S2),facet capsule(L3-S1)and ligamentum flavum(L3-5).In the control group,33 perivertebral soft tissue injuries distributed in supraspinous ligament(L4-5),interspinous ligament(L3-5),spinous spinous muscle(L1-5),multifissure muscle(L3-5)and small joint capsule(L3-4).The number of soft tissue injuries in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion IVD is prone to soft tissue injury around the vertebra,and the higher the level of degeneration,the higher the morbidity of perivertebral soft tissue inju
作者
欧阳林
丁益强
汤奕林
林祺
杨立杰
肖玉辉
OUYANG Lin;DING Yi-qiang;TANG Yi-lin;LIN Qi;YANG Li-jie;XIAO Yu-hui(Department of Pain and Rehabilitation,909th Hospital of the Joint Logistics Support Force of PLA,Zhangzhou,Fujian 363000,China)
出处
《中国骨与关节损伤杂志》
2020年第11期1133-1135,共3页
Chinese Journal of Bone and Joint Injury
基金
福建省区域发展项目(2019Y3007)
军队后勤科研项目(CLB18J060,CWH17L029)
漳州市科技拥军项目(ZZ2018KD01)。
关键词
椎间盘退变
椎周软组织损伤
核磁共振成像
Intervertebral disc degeneration
Perivertebral soft tissue injury
Magnetic resonance imaging
