CT分析退行性腰椎侧凸伴椎体侧方滑脱的解剖学变化

Anatomic changes of lateral spondylolisthesis associated with degenerative lumbar scoliosis:A CT analysis

背景:以前的研究主要集中于探讨椎体侧方滑脱与腰椎侧凸曲线变化及与疼痛之间的关系,很少有关于椎体侧方滑脱解剖学变化的详细报道。目的:观察退行性腰椎侧凸所致椎体侧方滑脱的解剖学改变。方法:选择烟台毓璜顶医院收治的退行性腰椎侧凸伴椎体侧方滑脱患者21例,男9例,女12例;年龄54～72岁,平均65岁;所有患者均行腰椎CT检查。通过腰椎冠状面重建CT图像测量椎体侧方滑脱距离,采用Aaro法在轴位CT图像上测量椎体旋转角度。结果与结论:椎体侧方滑脱在远端终椎非常多见,滑脱部位上端椎体向主弧曲线的凸面旋转,而下端椎体则向主弧曲线的凹面旋转。Cobb角平均值为25°,椎体侧方滑脱距离及旋转角度平均值分别为6.5mm、6.7°,椎体侧方滑脱距离(X)与椎体旋转角度(Y)间有显著的相关性(rs=0.63;P<0.01)。

BACKGROUND：Previous studies mainly focus on spondylolisthesis and lumbar scoliosis curvature changes and correlation with pain. However,there has not been any detailed report concerning anatomic changes in lateral spondylolisthesis. OBJECTIVE：To observe the anatomic changes in lateral spondylolisthesis associated with degenerative lumbar scoliosis （DLS）. METHODS：A total of 21 consecutive patients with lateral spondylolisthesis associated with DLS,including 9 males and 12 females,aged 65 years （range 54-72 years）,were selected. They were examined by CT. Coronal reconstruction CT was used to measure the vertebral translation. Vertebral rotation was measured by the Aaro method using transaxial CT. RESULTS AND CONCLUSION：Lateral spondylolisthesis was most commonly observed at the lower-end vertebra. The cephalad-slipped vertebra rotated toward the convex side of the main curve,whereas the caudal vertebra rotated toward the concave side of the main curve. The Cobb angle averaged 25°. Mean lateral translation and vertebral rotation were 6.5 mm and 6.7°,respectively. There was a significant correlation between lateral translation and vertebral rotation （rs=0.63; P 0.01）.