下背痛矿工脊柱退变的CT研究

Study on vertebral degenerations of coal miners with low back pain by means of computerized tomography

目的 为了解井下矿工腰脊柱退行性变情况 ,探讨下背痛的原因。方法 选择 40名有下背痛史、年龄 30～ 5 0岁、工龄 10～ 30年的井下矿工作为观察组 ;同时选择年龄、工龄和身高等相近的井上体力劳动者作为对照组 ;用GEProspeedAI型CT机对两组人群腰 (骶 )椎间盘 (L3/L4、L4/L5、L5 /S1)进行扫描 ,比较两组椎间盘突出、椎管矢状径大小、侧隐窝高度、椎体骨质增生、韧带肥厚等。结果 观察组L3/L4、L4/L5、L5 /S1椎间盘突出 (0 .33± 0 .15、0 .5 3± 0 .2 5、0 .45± 0 .18)较对照组 (0 .2 8± 0 .11、0 .32± 0 .2 1、0 .37± 0 .19)明显 ;侧隐窝高度 (0 .40± 0 .0 8、0 .31± 0 .0 5、0 .37± 0 .0 7)比对照组 (0 .42± 0 .10、0 .43± 0 .0 7、0 .40± 0 .0 6 )窄 ,但仅L4/L5水平差异有显著性 (P <0 .0 1) ;椎管矢状径大小比对照组窄 ,但差异无显著性 (P >0 .0 5 ) ;椎体骨质增生 (4 5 .0 0 %)、韧带肥厚 (4 2 .5 0 %)及钙化 (2 2 .5 0 %)比对照组 (2 3.33%、16 .6 7%、16 .6 7%)多见 ,但两组间仅韧带肥厚发生率的差异有显著性 (P <0 .0 5 )。结论 井下矿工腰脊柱退行性变比对照组严重 ,主要表现为L4/L5椎间盘突出和侧隐窝变窄。

Objective To study lumbar vertebral degenerations of coal miners with low back pain. Methods 40 underground miners with low back pain,aged from 30 to 50 years and employed for a length from 10 to 30 years,were taken as observasion group.30 ground workers without low back pain but with almost the same age,employment length and height etc.were selected as control group.Intervertebral discs at L3/L4,L4/L5,L5/S1 were scanned with computerized tomography,comparing herniated discs,sagittal diameter of vertebral canal,height of lateral recess,vertebral hyperostosis,ligament hypertrophy and calcification between two groups. Results L3/L4,L4/L5,L5/S1 herniated discs and narrow lateral recess in observation group(0.33±0.15,0.53±0.25,0.45±0.18 and 0.40±0.08,0.31±0.05,0.37±0.07) were more serious than that in control group(0.28±0.11,0.32±0.21,0.37±0.19 and 0.42±0.10, 0.43±0.07,0.40±0.06),but only with significant difference at L4/L5 (P<0.01).Sagittal diameter of vertebral canal in observation group is narrower than that in control group but of little significance(P>0.05).Cases of vertebral hyperostosis,ligament hypertrophy and calcification were found more frequent in observation group(45.00%,42.50%,22.50%) than in control group(23.33%,16.67%,16.67%),but only ligament hypertrophy was remarkable(P<0.05). Conclusions As compared with control group lumbar vertebral degenerations are more serious in underground miners with manifestations like herniated disc and narrow lateral recess mainly at L4/L5.