峡部裂性腰椎滑脱CT下小关节形态学测量的意义

Significance of lumbar facet joint morphology assessment with CT for patients of isthmic spondylolisthesis

目的:探讨腰椎小关节的形态在峡部裂性腰椎滑脱发生中的关系。方法:对30例峡部裂性腰椎滑脱患者及30名正常人,通过CT扫描结果进行对照检查。结果:对照组与峡部裂性腰椎滑脱组的L3/4和L4/5小关节角分别为52.3°、45.1°和44.2°、34.0°,差别具有统计学意义(P<0.05)。与对照组相比,峡部裂性滑脱组的L4/5小关节横径减少,L3/4和L4/5的小关节的不对称程度也具有统计学意义(P<0.05)。结论:峡部裂性腰椎滑脱患者的下腰椎小关节角偏向冠状位面,小关节横径减少,接触面积增大是其发病的原因之一,小关节的不对称性则加速了疾病的发展。

Objective： To find out the relationship of the morphology of lumbar facet joint and isthmie spondylolisthesis （ISS）. Methods：Thirty patients with ISS underwent CT scan ,for measuring the facet joint angle and transverse dimension of a facet joint at L3/4 ,L4/5 and L5/S1 ,and another 30 healthy subjects were employed as controls for this study. Results：Mean angle by axial facet joints orientation at L3/4 and L4/5 was 52.3° and 45.1° for the controls and 44.2° and 34.0° for ISS patients, respectively,which was different between the two groups （ P 〈 0.05 ）. Still, as compared with the controls, the ISS patients were found with decreased diameter in transverse dimension and marked asymmetry of the facet joint and marked asymmetry（ P 〈 0. 05 ）. Conclusion ： Isthmic spondylolisthesis may be resulted from the orientation of the lower lumbar facet / angles forward the coronal view, reduced diameter in transverse dimension and thus increased contact area of the facet joints, and asymmetry of the facet joint may lead to rapid development of this disease.