椎间小关节角度及多裂肌形态与真、假性腰椎滑脱的相关性研究

Pertinence Research of Intervertebral Facet Joint Angle and Polycleft Muscle Morphology for Distinguishing True and False Lumbar Spondylolisthesis

目的:研究椎间小关节角度及多裂肌形态与真、假性腰椎滑脱的相关性。方法:选取我院收治的腰椎滑脱患者100例和同期43例健康体检者作为研究对象,使用GE64排CT分别测量每一位入选者椎间多裂肌净横截面面积(LCSA)、多裂肌区域横截面面积(GCSA)及椎间小关节角度,根据CT检查结果将腰椎患者分为真性组和假性组,43例健康体检者为正常组。分析各组不同腰椎节段LCSA/GCSA比值和椎间小关节角度的差异。结果:真性组、假性组、正常组任意滑脱部位各节段LCSA/GCSA比值比较均具有统计学差异(P<0.05),真性组各节段LCSA/GCSA比值均比假性组低(P<0.05)。真性组、假性组各节段椎间小关节角均大于正常组(P<0.05),对应各滑脱节段,真性组该节段椎间小关节角度大于假性组(P<0.05)。L3滑脱者,L3/L4节段LCSA/GCSA比值最低,椎间小关节角度最大(P<0.05),L4滑脱者,L4/L5节段LCSA/GCSA比值最低,椎间小关节角度最大(P<0.05);L5滑脱者,L5/S1节段LCSA/GCSA比值最低,椎间小关节角度最大(P<0.05)。结论:腰椎滑脱患者椎间小关节角度和多裂肌形态发生改变,且真性腰椎滑脱者LCSA/GCSA比值更低,椎间小关节角度越大,使用不同节段LCSA/GCSA比值和椎间小关节角度可用于判断腰椎滑脱情况。

Objective:To investigate the pertinence of intervertebral facet joint angle and polycleft muscle morphology for distinguishing true and false lumbar spondylolisthesis.Methods:A total of 100 acute lumbar spondylolisthesis patients and 43 healthy people in our hospital were selected as study subjects. The LCSA, GCSA and intervertebral facet joint angle tested with CT scanner. 100 patients were divided into false group and true group based on the CT result. 43 healthy people were normal group. The LCSA/GCSA ratio of different lumbar segments and the intervertebral facet joint angle in each group were analyzed.Results:LCSA/GCSA ratios of all segments at any slip site in each group were statistically different(P<0.05). LCSA/GCSA ratios at any slip site of true group was lower than false group(P<0.05). The intervertebral facet joint angle of true group and false group were larger than normal group(P<0.05). To each slip site, the intervertebral facet joint angle of true group was larger than false group(P<0.05). For L3 slip, the LCSA/GCSA ratio of L3/L4 was lowest and intervertebral facet joint angle largest(P<0.05). For L4 slip, the LCSA/GCSA ratio of L4/L5 was lowest and intervertebral facet joint angle largest(P<0.05). For L5 slip, the LCSA/GCSA ratio of L5/S1 was lowest and intervertebral facet joint angle largest(P<0.05).Conclusion:The LCSA/GCSA ratio of true lumbar spondylolisthesis is lower and the intervertebral facet joint angle is larger. The LCSA/GCSA ratio of different segments and the intervertebral facet joint angle can be used to judge the situation of lumbar spondylolisthesis.