Schmorl结节在腰腿痛患者中的分布特点及与腰椎间盘退变的关系分析

The Distribution Characteristics of Schmorl Nodules in Patients with Low Back and Leg Pain and Its Relationship with Lumbar Disc Degeneration

目的探讨Schmorl结节在腰腿痛患者中的分布特点及与腰椎间盘退变的关系。方法在钦州市第一人民医院2016年1月—2019年1月期间骨外科门诊及住院的因腰椎间盘退变所致的腰腿痛患者中方便选取1 508例作研究对象,均予以腰椎MRI检查,并应用Pfirrmann分级法对患者腰椎间盘退变程度予以分级,统计Schmorl结节在腰腿痛患者腰椎上的分布特点及其与患者年龄、身高、性别等因素之间关系,并评估Schmorl结节与腰椎间盘退变程度分级之间的相关性。结果①该组1 508例腰腿痛患者共7 540个节段中,有338个腰椎终板产生了Schmorl结节改变,在腰椎间盘退变中发生率是4.48%;②Schmorl结节的形成与体重、身高无明显相关性,差异无统计学意义(P>0.05),而性别、年龄有关,男性患者和高龄患者的Schmorl结节形成率较高,差异有统计学意义(χ^2=10.974,P=0.001;t=2.972,P=0.041);③Schmorl结节累及终板情况与腰椎间盘退变Pfirrmann分级密切相关,差异有统计学意义(P<0.05)。结论 Schmorl结节的形成与患者年龄、性别和腰椎退变分级存在密切关系,Schmorl结节的形成可加速腰椎间盘退变,应高度重视。

Objective To investigate the distribution characteristics of Schmorl nodules in patients with low back and leg pain and its relationship with lumbar disc degeneration.Methods A total of 1508 patients with low back and leg pain caused by lumbar disc degeneration in the orthopedic surgery clinic and hospitalization period from January 2016 to January 2019 in Qinzhou First People's Hospital were conveniently selected as the research subjects.MRI examination and Pfirrmann grading method were used to classify the degree of degeneration of the lumbar intervertebral disc of patients.The distribution characteristics of Schmorl nodules on the lumbar spine of patients with low back and leg pain and the relationship with the patient’s age,height,gender and other factors were counted,and the correlation between Schmorl nodules and the grade of lumbar disc degeneration was evaluated.Results 1.In this group of 1508 patients with low back pain,there were 338 lumbar endplates with Schmorl nodules in 7540 segments.The incidence of lumbar disc degeneration was 4.48%;2.The difference was not statistically significant correlation between Schmorl nodules and body weight and height,the difference was not statistically significant(P>0.05),while gender and age were related.The formation rate of Schmorl nodules in male patients and elderly patients was higher,the difference was statistically significant(χ2=10.974,P=0.001;t=2.972,P=0.041);3.Schmorl Nodule involvement in the endplate was closely related to the Pfirrmann classification of lumbar disc degeneration,the difference was statistically significant(P<0.05).Conclusion The formation of Schmorl nodules is closely related to the patient's age,gender and grade of lumbar degeneration.The formation of Schmorl nodules can accelerate the degeneration of lumbar intervertebral discs and should be paid attention to.