非典型性Scheuermann病的MRI和间盘突出关系的研究

Study on the Relationship between Atypical Scheuermann's Disease MRI and Intervertebral Disk Protrusion

目的 :探讨非典型Scheuermann病 (ASD)的临床特点及其与破碎型间盘突出的区别。方法 :研究ASD的MRI特征表现及其与间盘突出的相关性及影响因素。结果 :ASD多累及腰间盘 ,占49%(540/1102)。ASD中SN多见于终板矢状面的中后1/3交界处 ,占45 1 % (631/1400)。按Serenson诊断标准将患者分为ASD组和非ASD组 ,前者和后者伴发间盘突出发生率的差别及年龄段间 (30～69岁 )间盘突出发生率的差别有统计学意义 (P<0.05) ;腰间盘与颈、胸段间盘突出发生率、双终板和单终板多发SN的间盘与单终板单发SN者间盘突出发生率、SN位于终板中后1/3交界部位与其它部位致间盘突出发生率间的差别均有统计学意义 (P<0.05或P<0.01)。结论 :ASD造成的间盘突出病理基础是完整椎间盘的发育异常部分与周围间盘相连结。治疗只有将挤压神经根或脊髓的间盘后缘彻底切除 。

Objective:To investigate the characters of clinical manifestation of ASD and the difference beˉtween ASD and intervertebral disc herniation.Methods:To study the typical MRI manifestation of ASD and the relation of ASD to disc degeneration and protrusion.Results:Two hundred and two(25.6%)of789patients were diagnosed ASD.The involved lumbar vertebrae in ASD was about49%(540/1102).SNs found in ASD patients were mainly located at the place between the middle and post third of the vertebral endplate,and the percentage was about45.1%(631/1400).The associated posterior disc protrusion was more common in ASD group than that in control group.There was a significant difference between30ys and69ys(P<0.05).The lumbar discs were more susceptible to degeneration and protrusion than cervical and thoracic discs(P<0.05).The involveˉment of superior and inferior endplated and single endplate of multiple SN were more susceptible to protrusion than single endplate of one SN(P<0.01).The SNs located between the middle and post third of the vertebral endplate were more than others(P<0.05).The distribution of SNs at the endplate also had relations to disc protrusion.Conclusion:ASD can cause intervertebral disc protrusion.This kind of disc protrusion is continued as the abnormal developmental part to the whole disc.It's necessary for us to cut off the posterior protrusion part thoroughly to get full decompression of affected nerves and/or dural sac.