军事飞行人员腰椎磁共振检查结果及相关性分析

Results and implications of lumbar magnetic resonance imaging in military aircrews

目的探讨不同年龄、不同机种飞行人员腰椎磁共振成像(magnetic Resonance Imaging,MRI)检查结果及与腰痛和(或)神经根症状之间的关系。方法回顾性分析行腰椎MRI检查的453名飞行人员的临床及影像学资料,并结合年龄、机种等资料进行比较,分析所有飞行人员腰椎间盘膨出和(或)突出与腰痛和(或)神经根症状之间的相关性。结果不同年龄组飞行人员,腰椎间盘膨出和(或)突出发生率差异具有统计学意义(χ^(2)=64.074,P<0.001),41~55岁年龄组发生率高于31~40、20~30年龄组,差异有统计学意义(χ^(2)=12.749、30.570,P均<0.001);歼击机、运输机以及直升机飞行人员之间比较,腰椎间盘膨出和(或)突出发生率差异无统计学意义(χ^(2)=0.056,P=0.972);343个腰椎节段存在椎间盘膨出和(或)突出表现,其中发生在L4~5段及L5~S1段要明显多于L1~4段;腰椎MRI检查正常组与存在腰椎间盘膨出和(或)突出的飞行人员比较,腰痛和(或)神经根症状的发生率差异无统计学意义(χ^(2)=0.966,P=0.326)。结论腰椎MRI结果显示腰椎间盘退变在飞行人员中发生率高,并随着年龄增大检出率增加,不同机种飞行人员发生率相似,腰椎MRI检查可作为飞行人员评估腰痛病情及制定治疗方案使用。

Objective To explore the relationships between examination results of lumbar magnetic resonance imaging(MRI)and low back pain and/or nerve root symptoms in aircrews of different ages and aircraft types.Methods The imaging data of 453 aircrews who underwent lumbar MRI examination was retrospectively analyzed,and comparisons were made based on age,aircraft types and other data.The correlations between lumbar disc bulge and/or protrusion,low back pain,and/or nerve root symptoms in these aircrews were analyzed.Results The incidence of lumbar disc bulge and/or protrusion varied among aircrews of different age groups is a statistically significant difference(χ^(2)=64.074,P<0.001).The incidence in the group ages 41 to 55 was significantly higher than that of groups ages 31 to 40 and 20 to 30(χ^(2)=12.749,30.570,both P<0.001).There was no statistically significant difference in the incidence of lumbar disc bulge and/or protrusion between aircrews of fighters,transport aircraft and helicopters(χ^(2)=0.056,P=0.972).Disc bulge and/or protrusion was detected in 343 lumbar segments,which was more prevalent in L4/5 and L5/S1 segments than in L1/4 segments.There was no statistically significant difference in the incidence of lower back pain and/or nerve root symptoms between the normal lumbar spine MRI group and aircrews with lumbar disc herniation and/or protrusion(χ^(2)=0.966,P=0.326).Conclusion The results of lumbar MRI show that the incidence of lumbar disc degeneration is high among aircrews and similar across aircrews of different types of aircraft.The detection rate increases with age.There is no significant correlation between lumbar disc degeneration and clinical symptoms.Lumbar MRI can be used to evaluate the severity of low back pain and help opt for treatments in aircrews.