腰椎关节突关节不对称及腰椎间盘突出症的相关性研究.pdf

提 要 目的：探讨腰椎关节突关节不对称与腰椎间盘突出症发病的相关性。 方法：从 2008 年～2010 年间就诊的门诊和住院病人中选择 L4/5 椎间盘突出患 者64例和56例正常人，行腰椎CT轴向扫描检查。选取L4/5关节突关节层面扫描图 像，测量双侧关节突关节矢状位角度并计算双侧关节角度差值，以关节角差值≥10 °视为关节突关节不对称，比较两组资料关节突关节不对称的出现差异，进行相关性 分析。 结果：腰椎间盘突出症患者组 L4/5 双侧关节突关节不对称 28 例，对照组 L4/5 双侧关节突关节不对称9例，两组有显著性差异（P0.01）；患者组中男、女患者关 节突关节不对称例数相比无显著性差异（P0.05）；患者组中不同突出类型患者关节 突关节不对称例数相比无显著性差异（P0.05）；患者组关节突关节不对称程度与腰 椎间盘突出程度之间不存在直线相关性（P0.05）。 结论：关节突关节不对称使腰椎后柱结构的生物力学改变，可引起脊柱异常活动 度的增加，使两侧关节突和椎间盘的承载不均匀，增加椎间盘损伤的机会，是腰椎间 盘突出症发病的危险因素之一。腰椎关节突关节的不对称改变在椎间盘突出症的诊断 中可起指导作用，对腰椎间盘突出症的预防和康复均有一定意义。 关键词 腰椎间盘突出症；关节突关节；不对称 The research of the relationship between lumbar facet joint asymmetry and lumbar disc herniation Specialty: Orthopaedics of TCM Author: Li Jiangong Tutor: Dong Jianwen Abstract Objective:Asymmetry of lumbar facet joint disease and lumbar disc herniation associated. Methods:From 2008 to 2010 between the outpatient and inpatient treatment, choose L4 / 5 disc 64 patients and 56 normal subjects, lumbar axial CT scan. Select the L4 / 5 facet joint level scans to measure bilateral facet joint angle and calculate the bilateral sagittal joint angle difference between the joint angle difference ≥ 10 ° as a facet joint asymmetry, compared two sets of data asymmetric facet joint variance analysis of the correlation. Results:Lumbar disc highlight syndrome patients group L4/5 double side joint bursting joint does not symmetric 28 cases, controlled group L4/5 double side joint bursting joint does not symmetric 9 cases, two group has significantly sexual differences (P0.01); patients group in the men, and female patients joint bursting joint does not