小关节不对称—青少年腰椎间盘突出症的放射学特征

Facet Joint Asymmetry as a Radiologic Feature of Lumbar Intervertebral Disc Herniation in Children and Adolescents

目的 :成人与青少年腰椎间盘突出症中小关节不对称性的比较。方法 :研究组包括青少年组 2 5名患者 ,2 9个椎间盘和成人组 3 3名患者 ,5 0个椎间盘。使用CT测量每个小关节形态、小关节角、力矩臂角和长度。小关节不对称的诊断标准为 :双侧小关节的形态不同或双侧小关节角相差 10°以上。并比较了两组间小关节不对称的发生率及其与椎间盘突出的位置、类型以及椎间盘退变之间的关系。结果 :青少年组 (12个间盘 ,占 41% )小关节不对称的发生率明显高于成人组 (4个间盘 ,占 8% ) (P <0 .0 1)。小关节不对称与椎间盘突出的位置、类型以及椎间盘退变之间无统计学差异。结论 :小关节不对称性是青少年腰椎间盘突出症的一个放射学特点。

Objective:To determine the different distribution of the facet joint asymmetry between the adult and juvenile patients.Methods:The study group consisted of 29 levels of 25 patients aged 12～20 years(juvenile group)and 50 levels of 33 patients aged 30～49 years(adult group)who underwent posterior discectomy.The shape of facet joints,the facet joint angle and the moment arm angle and length were measured for each facet joint using computed tomography.Facet joint asymmetry was defined as the difference in facet joint shape or a difference of more than 10 degrees in facet joint angles between the right and left sides.The incidence of facet joint asymmetry and the relationships among the facet joint asymmetry and the location,type of disc herniation,and disc degeneration were examined in juvenile and adult groups.Results:The overall incidence of facet joint asymmetry was significantly higher in the juvenile group(12 levels,41%) than in the adult group(4 levels,8%; P <0.01).There were no significant relationships among the facet joint asymmetry,the location,type of disc herniation and disc degeneration.Conclusions:This result indicates that facet joint asymmetry is a radiologic feature of lumbar intervertebral disc herniation in children and adolescents.