腰椎小关节退变的相关因素及生物力学特点

Related factors and biomechanical characteristics of lumbar facet joint degeneration

背景:腰椎小关节退变近年来成为学者们研究的重点,认识腰椎小关节退变的危险因素对于预防以及减少脊柱损害具有关键性作用,并且了解其解剖结构对于治疗脊柱相关疾病及手术实施有着重要的指导意义。目的:简述腰椎小关节解剖学、组织学特性,总结能够引起腰椎小关节退变的相关危险因素。方法:利用计算机检索CNKI、万方、维普、PubMed、Elsevier和Web of Science数据库2018年3月至2019年9月有关腰椎小关节退变的文章,检索词为"腰椎小关节,关节囊,关节面方向,神经支配,骨性关节炎,生物力学,下腰痛,椎间盘退变,腰椎滑脱,腰椎退行性脊柱侧弯,lumbar facet joint,joint capsule,articulardirection,eneurosis,osteoarthritis,biomechanics,lowbackpain,intervertebraldisc degeneration,umbar spondylolisthesis,lumbar degenerative scoliosis"。查阅相关文章,包括综述、基础研究及临床研究,通过阅读标题及摘要进行初步筛选,排除与主题相关度低的文献,最终共纳入60篇文献进行结果分析。结果与结论:①腰椎小关节退变的主要危险因素包括年龄、性别、异常应力、关节面方向、关节不对称性、腰椎节段和椎间盘退变;②关节退变后会导致下腰痛、椎间盘退变、腰椎滑脱、退行性脊柱侧弯等临床疾病的发生和发展,严重影响患者的日常生活和工作,降低生活质量。因此,腰椎小关节在脊柱相关疾病的治疗中不应该被忽视。

BACKGROUND:Lumbar facet joint degeneration has become the focus of scholars’research in recent years.Understanding the risk factors of lumbar facet joint degeneration plays a key role in preventing and reducing the damage to spine health.Moreover,comprehending its anatomy has important guiding significance for the treatment of spine-related diseases and related operations.OBJECTIVE:To briefly describe the anatomy and histological characteristics of the lumbar facet joints,and summarize the risk factors of lumbar facet joints degeneration.METHODS:A computer-based search of CNKI,Wanfang database,VIP database,PubMed,Elsevier and Web of Science was performed with the search terms“lumbar facet joint,joint capsule,articular direction,eneurosis,osteoarthritis,biomechanics,low back pain,intervertebral disc degeneration,lumbar spondylolisthesis,lumbar degenerative scoliosis”for articles published from March 2018 to September 2019.Review,basic research and clinical research were screened by reading title and abstract.The studies with low relevance to the subject were excluded,and 60 studies were included in the final analysis.RESULTS AND CONCLUSION:(1)The main risk factors for lumbar facet joint degeneration include age,gender,abnormal stress,articular surface orientation,joint asymmetry,lumbar segment and disc degeneration.(2)When the joints degenerate,it can cause low back pain,disc degeneration,lumbar spondylolisthesis,degenerative scoliosis and other clinical diseases,which seriously affect people’s daily life and work,and reduce people’s living quality.Therefore,lumbar facet joints should not be ignored in the treatment of spine-related diseases.