腰椎小关节不对称与椎间盘及小关节退变的关系

Relationship of lumbar facet joint tropism with degeneration of the intervertebral disc and the facet joint

背景:腰椎小关节不对称与椎间盘退变程度之间的关系一直存在争议,并且国内在下腰痛患者中对小关节不对称与小关节退变程度之间关系的研究较少。目的:调查分析腰椎小关节不对称在腰椎间盘退变与小关节退变过程中的作用。方法:测量312例下腰痛患者共936个脊柱功能单位的小关节角度差值,差值<7°定义为小关节对称,差值≥7°定义为小关节不对称。对936个脊柱节段的椎间盘退变程度及小关节退变程度进行分级。结果与结论:①小关节是否对称在年龄及性别上差异无显著性(P>0.05)。②小关节不对称与椎间盘退变程度之间无显著关联(P>0.05)。③在L4～L5节段小关节不对称组比小关节对称组的小关节退变程度更重(P<0.01)。提示小关节不对称与椎间盘退变无明显影响,但在腰椎活动度最大的L4～L5节段,小关节不对称可能会引起小关节的退变。

BACKGROUND：The relationship between lumbar facet joint tropism and degeneration degree of the intervertebral disc and the facet joint is in dispute,and there are few studies about this in China.OBJECTIVE：To investigate the role of lumbar facet joint tropism in the degeneration of the intervertebral disc and the facet joint.METHODS：The differences of facet joint angles of 936 functional spinal units from 312 patients with low back pain were measured,which were 7° defined as lumbar facet symmetry ≥ 7° as tropism.The degeneration degrees of the intervertebral disc and the facet joint were classified.RESULTS AND CONCLUSION：①There were no significant differences in facet tropism between different ages and genders（P 0.05）.②No significant relation was found between intervertebral disc degeneration and facet tropism（P 0.05）.③Facet tropism was associated with a higher incidence of facet joint degeneration at L4-5 when compared with facet symmetry（P 0.01）.There was no significant correlation between lumbar facet tropism and disc degeneration.But at L4-L5,the active sites of segmental motion,facet tropism may result in facet joint degeneration.