下腰痛青年官兵腰椎间盘退变与腰椎前凸角的关系探讨

Relationship between lumbar lordosis and lumbar intervertebral disc degeneration in young soldiers

目的分析下腰痛青年官兵腰椎间盘退变与腰椎前凸角的关系。方法收集2016年1月-2019年1月某部120例下腰痛官兵影像学及病历资料,在PACS系统中获取腰椎正侧位X线片、腰椎MRI完整影像学资料,应用Pfirrmann腰椎间盘退变分级量表评价椎间盘退变程度,应用Surgimap软件测量腰椎前凸角,分析腰椎前凸角在椎间盘退变不同分级各组、腰椎间盘突出组与非突出组之间的差异。结果120例下腰痛青年官兵腰椎前凸角平均值为42.99°±10.48°,腰椎间盘退变Pfirrmann分级Ⅰ~Ⅳ级各组的腰椎前凸角分别为46.00°±8.44°、45.36°±11.45°、41.43°±8.94°、40.88°±12.16°,四级组间比较无统计学差异(P=0.176),但Ⅰ~Ⅱ级组与Ⅲ~Ⅳ组之间相比,腰椎前凸角差异有统计学意义(45.53°±10.66°vs41.24°±10.06°,P=0.026)。腰椎间盘突出71例(59.17%),其中L4-5/L5-S1节段突出65例(91.54%),单一节段突出48例(67.6%),多节段突出23例(32.4%)。腰椎间盘突出组和非腰椎间盘突出组相比,腰椎前凸角差异有统计学意义(41.38°±10.96°vs 45.33°±9.36°,P=0.042)。结论本组下腰痛青年官兵腰椎间盘临床退变及椎间盘突出可能与腰椎前凸角的减小有关。

Objective To analyze the relationship between lumbar lordosis(LL)and intervertebral disc degeneration in young soldiers.Methods From January 2016 to January 2019,radiographic and clinical data about 120 young soldiers and officers with low back pain were collected,and the imaging data of X-ray and MRI of lumbar spine were collected through PACS film system.The lumbar intervertebral disc degeneration was measured with Pfirrmann classification of lumbar intervertebral disc degeneration scale,and the lumbar lordosis angle was measured with Surgimap software.Comparison of lumbar lordosis angle among different groups,including different disc degeneration grade groups,lumbar disc herniation group(LDH)versus non-lumbar disc herniation group(N-LDH),was performed.Results Of the 120 cases,the average LL was 42.99°±10.48°.The LL in disc degeneration gradeⅠ,gradeⅡ,gradeⅢ,gradeⅣsubgroups were 46.00°±8.44°,45.36°±11.45°,41.43°±8.94°,40.88°±12.16°,respectively,without significant difference(P=0.176).However,there was significant difference betweenⅠ-Ⅱgroup andⅢ-Ⅳgroup in average LL(45.53°±10.66°vs 41.24°±10.06°,P=0.026).Of the 120 soldiers,71(59.17%)cases had lumbar disc herniation with 65(91.45%)cases at L4-5/L5 S1.There was significant difference between LDH group and N-LDH group in average LL(41.38°±10.96°vs45.33°±9.36°,P=0.042).Conclusion The lumbar intervertebral disc degeneration and LDH are probably associated with the decrease of LL in the young soldiers.