腰椎关节突三维角度与单节段同水平腰椎间盘突出相关性研究

Study on the relationship between the three-dimensional angle of lumbar facet and single level lumbar disc herniation

目的:探讨腰椎关节突三维角度与单节段同水平腰椎间盘突出的相关性。方法:选取2018年6月—2019年6月我院收治的单纯性单节段腰间盘突出患者105例,选取同期无腰椎疾病患者60例为对照组。采用CT及X线测定腰椎3个平面L3~S1关节突角度。随后采用Fujiwara标准进行分级,按照腰椎间盘突出等级分为3组对比滑脱程度。结果:在横断面上,腰椎间盘突出患者关节突不对称比率明显大于对照组(P<0.05),且关节突角更偏矢状位。在冠状位上,腰椎间盘突出患者两侧关节突不对称比率明显大于对照组(P<0.05),且小关节角更偏竖直位。在矢状位上,腰椎间盘突出患者更偏水平位(P<0.05)。腰椎间盘突出患者关节突存在不同程度的突出(Ⅱ~Ⅳ度),按照关节突关节的突出等级将腰椎间盘突出患者分为3组,各组间突出指数差异无统计学意义(P>0.05)。腰椎间盘突出患者关节突角度与突出程度具有相关性(r=0.755,P<0.05)。结论:腰椎关节突角度与单节段同水平腰椎间盘突出具有一定的相关性。

Objective:To explore the relationship between the three-dimensional angle of lumbar facet and single level lumbar disc herniation.Methods:From June 2018 to June 2019,105 patients with simple single segment lumbar disc herniation and 60 patients without lumbar disease in the same period were selected as the control group.The protrusion angles of L3-S1 joints in three planes of lumbar spine were measured by CT and X-ray.Then,Fujiwara standard was used for classification and the degree of lumbar disc herniation was divided into three groups.Results:In the cross section,the ratio of facet asymmetry in patients with lumbar disc herniation was significantly higher than that in the control group(P<0.05)and the angle of protrusion was more sagittal.In the coronal position,the asymmetry ratio of bilateral facets in patients with lumbar disc herniation was significantly higher than that in the control group(P<0.05)and the facet angle was more vertical.In sagittal position,the angle in patients with lumbar disc herniation were more horizontal(P<0.05).Patients with lumbar disc herniation have different degrees of protrusion(Ⅱ-Ⅳdegrees).According to the protrusion level of joint process,the patients with lumbar disc herniation were divided into three groups.There was no significant difference in protrusion index between each group(P>0.05).There was a correlation between the angle and the degree of joint protrusion in patients with lumbar disc herniation(r=0.755,P<0.05).Conclusion:There is a certain correlation between the protrusion angle of lumbar facet and single level lumbar disc herniation.