腰椎椎间盘突出症患者腰骶部形态学

Lumbosacral morphology of lumbar disc herniation patients

目的 比较腰椎椎间盘突出症(LDH)患者与非LDH腰痛人群腰骶部形态学参数之间的差异,探讨LDH患者腰骶部形态学特征。方法 回顾性分析2016年1月—2017年1月南京鼓楼医院收治的107例LDH患者(LDH组)及72例腰背部疼痛人群(对照组)影像学资料。分别在站立位全脊柱侧位X线片上测量并比较2组研究资料的椎间盘角(IDA)、腰椎前凸角(LLA)、腰骶前凸角(LSLA)、骶骨倾斜角(SSA)及腰骶角(LSA)。结果 LDH组患者L4/L5和L5/S1节段IDA、LLA、SSA及LSA均低于对照组,差异有统计学意义(P<0.05)。L4/L5节段突出者的L4/L5节段IDA低于L5/S1节段突出者,而L5/S1节段突出者的L5/S1节段IDA则低于L4/L5节段突出者,差异均有统计学意义(P<0.05)。结论 LDH患者的LLA、SSA及LSA比正常人明显降低。LDH患者生理曲度的丢失主要由责任节段IDA的减小所致。

Objective To compare the difference in lumbosacral morphology between lumbar disc herniation(LDH)patients and non-LDH people with low back pain,and further summarize the characteristics of the lumbosacral morphology in LDH patients.Methods The imaging data of 107 LDH patients(LDH group)and 72 non-LDH people(control group)with low back pain admitted to Nanjing Drum Tower Hospital from January 2016 to January 2017 were retrospectively analyzed.The intervertebral disc angle(IDA),lumbar lordosis angle(LLA),lumbosacral lordosis angle(LSLA),sacral slope angle(SSA)and lumbosacral angle(LSA)were measured and compared on the standing lateral roentgenographs of the whole spine.Results The IDA(L4/L5 and L5/S1),LLA,SSA and LSA in the LDH group were lower than those in the control group,with statistical significance(P<0.05).In addition,the IDA of L4/L5 in patients with L4/L5 LDH were significantly lower than that in patients with L5/S1 LDH,while the IDA of L5/S1 in patients with L5/S1 LDH were significantly lower than that in patients with L4/L5 LDH,all with statistical significances(P<0.05).Conclusion Compared with normal people,the LLA,SSA and LSA would be significantly lower in LDH patients.The decrease of LLA in LDH patients should be mainly attributed to the IDA loss of the responsible intervertebral disc.