腰椎棘突偏斜与年轻患者腰椎间盘突出的相关性研究

Correlation between spinous process deviation and lumbar disc herniation in young patients

目的:探讨腰椎棘突偏斜与年轻患者(<30岁)腰椎间盘突出之间的相关性。方法:对2015年3月至2022年1月收治的30例年轻腰椎间盘突出患者(年轻组)进行回顾性分析。同时筛选纳入中老年腰椎间盘突出患者(中老年组)和非退行性病变的年轻脊柱脊髓疾病患者(年轻非退变组)各30例作为对照组。在CT上测量目标棘突的偏斜角度,通过各类分组进行统计学分析。结果:年轻组病变节段的棘突偏斜角度为(3.89±3.77)°,中老年组病变节段的棘突偏斜角度为(3.72±2.98)°,两组比较差异无统计学意义(P=0.851)。年轻非退变组棘突偏斜角度为(2.20±2.28)°,明显小于年轻组患者(P=0.040)。年轻组病变节段的上位椎体棘突的倾斜角度为(4.10±3.44)°,与中老年组的(3.47±2.87)°比较差异无统计学意义(P=0.447)。年轻组有19例患者病变节段和上位椎体棘突的倾斜方向相反,而中老年组仅有7例患者出现这种情况,两组比较差异有统计学意义(P=0.002)。年轻患者腰椎间盘突出方向与病变或者上位腰椎的棘突偏斜方向无明显关系(P>0.05)。结论:棘突偏斜可能是年轻人患腰椎间盘突出的危险因素。相邻腰椎棘突的偏斜方向相反是年轻患者的重要解剖特征,在此基础上会产生椎旁肌发育失衡,容易诱发腰椎间盘突出。椎间盘突出类型与病变椎体和上位椎体的棘突的偏斜方向无明显关联。有该解剖变异者可以通过合理锻炼,加强脊柱稳定性,预防腰椎间盘突出。

Objective To explore the relationship between spinous process deviation and lumbar disc herniation in young patients.Methods From March 2015 to January 2022,30 treated young(under the age of 30)patients with lumbar disc herniation were included as the young group.In addition 30 middle-aged patients(quinquagenarian group)with lumbar disc herniation and 30 patients with non-degenerative spinal diseases(young non-degenerative group)were selected as control groups.The angle of the spinous process deviation was measured on CT and statistically analyzed by various groups.All the data were measured twice and the average value was taken and recorded.Results The average angle of spinous process deviation in the degenerative lumbar vertebra of young patients were(3.89±3.77)degrees,similar to the(3.72±2.98)degrees of quinquagenarian patients(P=0.851).The average angle of s spinous process deviation young non-degenerative group were(2.20±2.28)degrees,significantly less than young group(P=0.040).The spinous process deviation angle of the superior vertebral of the degenerative lumbar in the young group was(4.10±3.44)degrees,which similar to the(3.47±2.87)degrees in the quinquagenarian group(P=0.447).A total of 19 young patients had the opposite deviation direction of the spinous process of the degenerative lumbar vertebra and upper vertebra,while only 7 quinquagenarian patients had this condition(P=0.02).The type of lumbar disc herniation in young patients had no significant relationship with the direction of spinous process deflection of the degenerative or upper lumbar vertebra(P>0.05).Conclusion Spinous process deviation is a risk factor of young lumbar disc herniation patients.If the deviation directions of adjacent lumbar spinous processes are opposite,it will increase the incidence of lumbar disc herniation in young patients.There was no significant correlation between the type of disc herniation and the deviation direction of the spinous process of the degenerative or upper lumbar vertebra.People with such anatomical variation can strengthen the stability of spine and prevent lumbar disc herniation through reasonable exercise.