腰椎相关结构的退变规律

Degenerating Rule of Lumbar Spine Correlated Structure

目的 研究腰椎退变患者腰椎骨质、椎间盘、韧带、椎小关节退变及腰椎退变性失稳与年龄、性别的相关性，探讨腰椎退变规律。资料与方法 对1180例腰椎退变患者的腰椎CT进行分析，观察不同年龄段、不同性别间椎体骨质、椎间盘、椎小关节、韧带退变以及退变性腰椎失稳的发生率。结果 腰椎退变患者腰椎间盘的退变率最高，其次是腰椎骨质、椎小关节、韧带、腰椎失稳。以36岁为年龄分界，36岁以下为腰椎低退变率年龄，以上是腰椎高退变率年龄，不同结构伴随年龄增长的退变率并不是同步递增的，腰椎骨质、椎小关节、韧带退变率及腰椎失稳发生率最高在65岁以上年龄段，而腰椎间盘退变率最高在36～45岁年龄段。男性腰椎间盘、骨质的退变率明显高于女性；椎小关节、韧带的退变率在男、女性间无显著差异；而女性腰椎失稳率明显高于男性。结论 总体上伴随年龄增长的腰椎退变，其不同结构的退变规律不一，在不同年龄段及性别间都存在明显差异，全面分析腰椎退变的影像表现有利于对腰椎退变性疾病的理解和治疗。

Objective To study the correlation of lumbar vertebra, intervertebral discs, ligaments, vertebra facet joint and degenerative destabilizing with age and sex in patient with lumbar spine degeneration disease, and explore the rule of lumbar spine degenerating. Material and method CT image of 1180 eases with lumbar spine degeneration disease were analyzed, and the degeneration incidence of lumbar vertebra selerotin, intervertebral discs, ligaments, vertebra facet joint and the degenerative destabilizing incidence in different age and sex were observed. Results In patients with lumbar spine degenerating, the degeneration incidence of intervertebral discs was the highest, by turns was lumbar vertebra selerotin, vertebra facet joint, ligaments and the degenerative destabilizing. Setting 36 years old as the dividing line, below it was lumbar spine low degeneration incidence age, upon it was high degeneration incidence age, the degeneration incidences accompanied with age of different structure were not at equal pace, the highest incidences of vertebra selerotin, vertebra facet joint and ligaments degenerating and of the degenerative destabilizing occurred upon 65 years old, however, the highest degeneration incidence of intervertebral discs occurred during the period of 36 - 45 years old. Man＇s degeneration incidence of intervertebral discs and lumbar vertebra selerotin was significantly higher than that of woman＇s, the degeneration incidence of vertebra facet joints and ligaments of man was equal to which of woman, however,woman＇s degenerative destabilizing incidence was significantly higher than that of man＇s. Conclusion In general, the lumbar spine degeneration is accompanied with increased of age, but its different structures degenerate at unequal pace, with significant difference in different age and sex, so comprehensive analyzing the image signs of lumbar spine degeneration is helpful to understand and treatment of lumbar spine degenerative disease.