椎板和小关节倾斜角与退变性腰椎滑脱的关系

Influence of laminar and facet inclination angle on degenerative lumbar spondylolisthesis

目的:探讨椎板和小关节倾斜角与退变性腰椎滑脱的关系。方法:收集徐州医学院附属医院2006年8月至12月腰椎X片,包括腰椎正侧片和左右45°斜位片。L4向前滑脱30例为滑脱组,随机选择51例为对照组,测量椎板倾斜角和小关节倾斜角,两样本均数的比较采用U检验。两侧腰椎小关节倾斜角的差值与滑脱程度采用Spearm an等级相关分析。结果:对照组与滑脱组L4椎板倾斜角比较差异有统计学意义(U=11.4,P<0.01);对照组与滑脱组的小关节倾斜角L4-5差异有统计学意义(U=12.4,P<0.01);小关节的对称性与滑脱程度之间有等级相关关系(?rs?=0.619,P<0.01)。结论:椎板倾斜角的增大,不利于腰椎的力学稳定,容易发生退变性腰椎滑脱。小关节倾斜角增大,其阻抗剪切能力减弱,椎体向前滑移的趋势增加。腰椎小关节对称性越差,滑脱程度越明显。

Objective： To study the influence of the laminar and facet inclination angles and facet tropism on the occurance of degenerative spondylolisthesis.Methods： The lumbar radiographs were collected at the Affiliated Hospital of Xuzhou Medical College from August 2006 to December 2006,including posterior-anterior,lateral and oblique radiographs of the lumbar.Thirty cases were L4 slipping,these patients were included in the study group,51 cases were considered as control group at random.The laminar inclination angle（LIA） and facet inclination angle（FIA） were assessed in each group.U-test was used by SPSS12.0.The relationship between facet tropism（FT）and slipping degree was analyzed by Spearman test. Results： The difference of L4 in LIA and FIA was significant（U=11.4,P〈0.01）.The difference of L4-5 in LIA and FIA was significant（U=12.4,P〈0.01）.The relationship between FT and slipping degree was significant（∣rs∣=0.619,P〈0.01）. Conclusion： Horizontalization of the lamina was a pathoanatomic risk factor that can predispose for the DLS.The facet tropism was associated with the degree of slipping in DLS.