青年L5 峡部应力骨折患者上关节突间距的解剖学特点

Anatomic characteristics of interval between superior articular process at L5 in young patients with L5 isthmus stress fracture

目的探讨青年L5峡部应力骨折患者L5双侧上关节突间距的解剖学特点。方法回顾性分析2018年3月—2019年9月解放军总医院第七医学中心收治的21例青年男性L5峡部应力性骨折患者的影像学资料(应力骨折组),并与24例健康青年男性志愿者影像学资料进行对比(对照组)。所有入组对象均拍摄腰椎CT及三维重建,并在CT上测量L5双侧上关节突顶点间距(a)和S1上关节突顶点间距(b),计算两者比值c(c=a/b),统计分析2组c值差异。结果应力骨折组患者c值高于对照组,2组比较差异具有统计学意义(P<0.05)。结论青年男性L5峡部应力骨折患者其L5上关节突间距增宽,S1上关节突间距相对较小,该解剖特点可能与峡部应力骨折的发生相关。

Objective To investigate the anatomic characteristics of the interval between the superior articular processes at L5 in the young patients with L5 isthmus stress fracture.Methods The imaging data of 21 young male patients with L5 isthmus stress fracture(stress fracture group)admitted to the Seventh Medical Center of PLA General Hospital from March 2018 to September 2019 were analyzed retrospectively,and compared with that of 24 young male volunteers(control group).All the subjects were photographed with lumbar CT and three-dimensional reconstruction,and the interval between bilateral apical of superior articular process of L5(a)and S1(b)were measured,and the a/b ratio value(c)between the 2 groups was calculated,and the difference of c value between the 2 groups was statistically analyzed.Results The c value of the stress fracture group was higher than that of the control group,and the difference between the 2 groups was statistically significant(P<0.05).Conclusion The young male patients with L5 isthmus stress fracture had an increased interval between the superior articular processes at L5 and decreased interval between the superior articular process at S1 compared with the young volunteers,and the anatomic characteristics might be associated with the high occurrence of L5 isthmus stress fracture.