关节突关节不对称及方向与青年人脱垂型腰椎间盘突出症的相关性分析

Correlation analysis of facet tropism and facet joint orientation with prolapsed subtype of lumbar disc herniation in young patients

目的:研究关节突关节不对称(FT)与青年人脱垂型腰椎间盘突出症(PSLDH)及关节突关节方向与青年人髓核脱出方向的关系。方法:选择401例PSLDH患者(PSLDH组)及267例无腰椎间盘突出症(LDH)患者(对照组)作为研究对象。在CT上测量PSLDH组脱垂节段(L4/5或L5/S1)的双侧关节突关节角度(FJA)和对照组L4/5、L5/S1两个节段的双侧FJA。定义FT为双侧FJA差值>10°。同时观察髓核脱垂的方向与关节突关节的方向。结果:PSLDH组与对照组在L4/5、L5/S1节段出现FT的例数差异有统计学意义(P<0.05)。在PSLDH组脱垂的节段中,脱垂一侧关节突关节方向形态为冠状位方向的例数与矢状位方向的例数相比无显著性差异(P=0.860)。结论:FT与青年人PSLDH在L4/5及L5/S1节段均存在相关性;关节突关节方向与青年人髓核脱垂方向无相关性。

Objective:To investigate the association between facet tropism(FT)and prolapsed subtype of lumbar disc herniation(PSLDH)in young patients,and the relationship between facet joint orientation and the side of prolapsed nucleus pulposus.Methods:Four hundred and one patients with prolapsed subtype of lumbar disc herniation and 267 patients without lumbar disc herniation(LDH)were selected as study subjects.Facet joint angles(FJAs)of prolapsed segment(L4-L5 or L5-S1)in patients with PSLDH,both at L4-L5 and L5-S1 segments in controls were measured by CT.We defined FT as the difference between the angle of the right and left facet joint greater than 10°.Also,we observed the side of prolapsed nucleus pulposus and facet joint orientation.Results:The two groups had a significant statistic difference in the number of FT at L4-L5 and L5-S1 segments(P<0.05).However,there was no significant statistical difference between the coronally oriented facet joint and the sagittally oriented facet joint in the same side of prolapsed nucleus pulposus.Conclusion:Facet tropism is associated with extruded lumbar disc herniation at both L4-5 and L5-S1 levels in young patients.However,there is no relationship between facet joint orientation(more coronally or sagittally oriented)and the side of prolapsed nucleus pulposus.