影像学正常人群腰椎椎间高度指数、椎间角度及腰椎前凸角度的研究分析

Analysis of lumbar intervertebral height index,intervertebral angle and lumbar lordosis angle in normal imaging population

目的测量影像学正常人群腰椎各个节段椎间高度指数(IHI)、椎间角度(IVA)及腰椎前凸角(LL),分析其变化特点。方法收集2014年1月至2016年10月因腰腿痛就诊于西京医院骨科门诊患者。其检查结果提示腰椎无明显异常且各节段椎间盘Pfirrmann分级(P-c)为Ⅰ级和Ⅱ级,共纳入303人。将其按年龄分为五组:青年组(20~29岁),青中年组(30~39岁),中年组(40~49岁),中老年组(50~59岁),和老年组(60岁以上),测量腰椎各个节段IHI、IVA及LL,分析其变化规律。结果 IHI从L_(1-2)向下逐渐增加,L_5-S_1节段达到最大,差异有统计学意义(P<0.05)。不同性别、不同年龄组及P-c分级Ⅰ级和Ⅱ级之间,在相同节段IHI差异无统计学意义(P>0.05)。IVA从L_(1-2)向下逐渐增加,L_5-S_1节段达到最大,差异有统计学意义(P<0.05)。不同年龄组之间IVA在L_(2-3)、L_(3-4)、L_(4-5)节段及LL差异有统计学意义(P<0.05),在L_(1-2)、L_5-S_1节段差异无统计学意义(P>0.05)。结论本研究获得了不同年龄组、不同性别影像学正常人群腰椎各个节段IHI、IVA及LL的正常值范围。在椎间盘尚未发生退变的情况下,腰椎椎间高度指数保持相对稳定,不随年龄、性别的变化发生变化。腰椎各节段IVA及LL随年龄改变发生改变,自进入青中年组以后,随着年龄增长,角度逐渐增大。

Objective This study is aimed at measuring the intervertebral height index （IHI）, intervertebral angle （IVA） in every lumbar segment and lumbar lordosis （LL） in normal imaging population, and analyzing its characteristics. Methods Collecting out patients from Jan 2014 to Oct 2016 in Xijing hospital department of orthopedics and imaging examination shows no obvious disease and Pfirrmann Scale changes （P-c） were less than or equal to II grade. A total of 303 people had been divided into five groups according to age： young group （20-29 years old）; young and middle aged group （30-39 years old）; middle aged group （40-49 years old）; middle aged and aged group （50-59 years old）; aged group （over 60 years）. Using Surgimap software to get the following parameters in lateral radiographs： IHI,IVA in every lumbar segment and LL. Analyzing the changes of IHI, IVA and LL in different age, gender and P-c groups. Results The IHI is gradually increased from Li.2to Ls-Si, and it＇s statistically significant （P〈0.05）. Ls-Si segment has reached maximum. Comparing the difference in different age, gender and P-G groups in the same segment, there is dif-ference in IHI, but no statistical significance （P〉0.05）. The IVA is gradually increased from Li.2 to L5 -Si and it＇s statisticallysignificant （P〈0.05）, L5-S1 segment has reached maximum. Comparing the different age groups, there is significance difference （P〈0.05） in IVA at L2- 3,L34,L‘5 segments and LL, but no statistical significance in Li- 2, L5-S1 segment （P〉0.05）. Conclusion This study got the normal range of IHI, IVA in every lumbar segments and LL in normal imaging population. At no degenerative grade degeneration disc, the lumbar spine IHI remained unchanged and did not vary with age or gender. The changes of IVA and LL in each segment of the lumbar spine varied with age. After entering the middle- aged group, the angle gradually increased with age.