体重指数、关节突关节角度与退变性腰椎滑脱的相关性分析
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摘要
目的探讨体重指数、关节突关节角度变化与退变性腰椎滑脱的相关性。方法选取2016年1月至2017年11月在我院诊断为退变性腰椎滑脱的患者共45例,通过收集同期在我院体检患者90例作为正常组,记录患者体重指数,测量L4～5头侧关节突关节角、尾侧关节突关节角、关节突-椎弓根角、左右关节突关节角是否对称,并对这些参数与退变性腰椎滑脱进行相关性分析。结果退变性腰椎滑脱组与正常组相比较,在体重指数、头侧关节突关节角、尾侧关节突关节角、关节突-椎弓根角之间差异有统计学意义(P<0.05);退变性腰椎滑脱组与体重指数、头侧关节突关节角、关节突-椎弓根角可能存在相关性(P<0.05);退变性腰椎滑脱组中左右关节突关节角是否对称与滑脱程度间差异具有统计学意义(P=0.04)。结论退变性腰椎滑脱患者与正常人相比较关节突关节角更加趋于矢状化、关节突-椎弓根角趋于水平化。
Objective To explore the correlation between the body mass index,lumbar facet joint angle and degenerative lumbar spondylolisthesis.Methods A total of 45 cases diagnosed as degenerative lumbar spondylolisthesis in our hospital from January 2016 to November 2017 were enrolled.And 90 cases of healthy controls who had health checkup during the same time were included in normal group.The body mass index was recorded,the lumbar facet joint angle of L4～5at the cranial side and the caudal side as well as the facet-pedicle angle were measured,and the left and right lumbar facet joint angle were inspected for symmetry.Results Compared with the normal group,the body mass index,the lumbar facet joint angle at the cranial side and the caudal side as well as the facet-pedicle angle were significantly different in the degenerative lumbar spondylolisthesis group(P<0.05).There were possible correlations between the body mass index,the lumbar facet joint angle at the cranial side as,the facet-pedicle angle and degenerative lumbar spondylolisthesis(P<0.05).Also,there was statistical difference between the symmetry of the left and right lumbar facet joint angle and the spondylolisthesis degree in the degenerative lumbar spondylolisthesis group(P =0.04).ConclusionCompared with normal people,the lumbar facet joint angle is more sagittal and the facet-pedicle angle was more horizontal in the patients with degenerative lumbar spondylolisthesis.
Objective To explore the correlation between the body mass index,lumbar facet joint angle and degenerative lumbar spondylolisthesis.Methods A total of 45 cases diagnosed as degenerative lumbar spondylolisthesis in our hospital from January 2016 to November 2017 were enrolled.And 90 cases of healthy controls who had health checkup during the same time were included in normal group.The body mass index was recorded,the lumbar facet joint angle of L4～5at the cranial side and the caudal side as well as the facet-pedicle angle were measured,and the left and right lumbar facet joint angle were inspected for symmetry.Results Compared with the normal group,the body mass index,the lumbar facet joint angle at the cranial side and the caudal side as well as the facet-pedicle angle were significantly different in the degenerative lumbar spondylolisthesis group(P<0.05).There were possible correlations between the body mass index,the lumbar facet joint angle at the cranial side as,the facet-pedicle angle and degenerative lumbar spondylolisthesis(P<0.05).Also,there was statistical difference between the symmetry of the left and right lumbar facet joint angle and the spondylolisthesis degree in the degenerative lumbar spondylolisthesis group(P =0.04).ConclusionCompared with normal people,the lumbar facet joint angle is more sagittal and the facet-pedicle angle was more horizontal in the patients with degenerative lumbar spondylolisthesis.
引文
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[14]苏少亭,周红海,梁栋,等.腰椎关节突关节的生物力学研究进展[J].中国脊柱脊髓杂志,2017,27(5):474-479.
[15]Noailly J,Planell JA,Lacroix D.On the collagen criss-cross angles in the annuli fibrosi of lumbar spine finite element models[J].Biomechanics&Modeling in Mechanobiology,2011,10(2):203-219.
[16]Yunoki S,Hatayama H,Ebisawa M,et al.A novel fabrication method to create a thick collagen bundle composed of uniaxially aligned fibrils:An essential technology for the development of artificial tendon/ligament matrices[J].J Biomed Mater Res A,2015,103(9):3054-3065.
[17]Kim JS,Ali MH,Wydra F,et al.Characterization of degenerative human facet joints and facet joint capsular tissues[J].Osteoarthritis&Cartilage,2015,23(12):2242-2251.
[18]Toyone T,Ozawa T,Kamikawa K,et al.Facet joint orientation difference between cephalad and caudad portions:apossible cause of degenerative spondylolisthesis[J].Spine(Phila Pa 1976),2009,34(21):2259.
[19]Don AS,Robertson PA.Facet joint orientation in spondylolysis and isthmic spondylolisthesis[J].JSpinal Disord Tech,2008,21(2):112-115.
[20]许伏龙,朱青安,王吉星,等.关节突关节倾斜度与退行性腰椎滑脱的相关性研究[J].实用骨科杂志,2017,23(8):707-710;732.
[21]郭马超,鲁世保,孔超.小关节角度和不对称性在L4~5退变性滑脱发生中的作用[J].实用骨科杂志,2018,24(7):584-588.
[22]Reid IR.Relationships among body mass,its components,and bone[J].Bone,2002,31(5):547-555.
[23]Kalichman L,Guermazi A,Li L,et al.Association between age,sex,BMI and CT-evaluated spinal degeneration features[J].J Back Musculoskelet Rehabil,2009,22(4):189-195.
[24]Rankine JJ,Dickson RA.Unilateral spondylolysis and the presence of facet joint tropism[J].Spine(Phila Pa 1976),2010,35(21):1111-1114.
[2]Iguchi T,Wakami T,Kurihara A,et al.Lumbar multilevel degenerative spondylolisthesis:radiological evaluation and factors related to anterolisthesis and retrolisthesis[J].J Spinal Disord Tech,2002,15(2):93-99.
[3]Laus M,Tigani D,Alfonso C,et al.Degenerative spondylolisthesis:lumbar stenosis and instability[J].Chir Organi Mov,1992,77(1):39-49.
[4]Sengupta DK,Herkowitz HN.Degenerative spondylolisthesis:review of current trends and controversies.[J].Spine,2005,30(6Suppl):71-81.
[5]Funao H,Tsuji T,Hosogane N,et al.Comparative study of spinopelvic sagittal alignment between patients with and without degenerative spondylolisthesis[J].Eur Spine J,2012,21(11):2181-2187.
[6]李永新,尹利荣,王沛,等.关节突关节形态与退行性腰椎滑脱的关系[J].天津医科大学学报,2010,16(1):87-89;92.
[7]许勇,云才,郭昭庆.腰椎小关节在退变性腰椎滑脱发病机制中的作用[J].中国医师进修杂志,2012,35(21):1-3.
[8]Noren R,Trafimow J,Andersson GB,et al.The role of facet joint tropism and facet angle in disc degeneration[J].Spine(Phila Pa 1976),1991,16(5):530-532.
[9]闫广辉,徐宝山,夏群,等.腰椎小关节方向性与腰椎间盘突出症[J].中国组织工程研究与临床康复,2011,15(35):6563-6566.
[10]Grogan J,Nowicki BH,Schmidt TA,et al.Lumbar facet joint tropism does not accelerate degeneration of the facet joints[J].AJNR Am J Neuroradiol,1997,18(7):1325-1329.
[11]Berlemann U,Jeszenszky DJ,Bühler DW,et al.Facet joint remodeling in degenerative spondylolisthesis:an investigation of joint orientation and tropism[J].Eur Spine J,1998,7(5):376-380.
[12]Claeson AA,Barocas VH.Computer simulation of lumbar flexion shows shear of the facet capsular ligament[J].Spine J,2016,17(1):109-119.
[13]ivancic PC.Biomechanics of thoracolumbar burst and chance-type fractures during fall from height[J].Global Spine J,2014,4(3):161-168.
[14]苏少亭,周红海,梁栋,等.腰椎关节突关节的生物力学研究进展[J].中国脊柱脊髓杂志,2017,27(5):474-479.
[15]Noailly J,Planell JA,Lacroix D.On the collagen criss-cross angles in the annuli fibrosi of lumbar spine finite element models[J].Biomechanics&Modeling in Mechanobiology,2011,10(2):203-219.
[16]Yunoki S,Hatayama H,Ebisawa M,et al.A novel fabrication method to create a thick collagen bundle composed of uniaxially aligned fibrils:An essential technology for the development of artificial tendon/ligament matrices[J].J Biomed Mater Res A,2015,103(9):3054-3065.
[17]Kim JS,Ali MH,Wydra F,et al.Characterization of degenerative human facet joints and facet joint capsular tissues[J].Osteoarthritis&Cartilage,2015,23(12):2242-2251.
[18]Toyone T,Ozawa T,Kamikawa K,et al.Facet joint orientation difference between cephalad and caudad portions:apossible cause of degenerative spondylolisthesis[J].Spine(Phila Pa 1976),2009,34(21):2259.
[19]Don AS,Robertson PA.Facet joint orientation in spondylolysis and isthmic spondylolisthesis[J].JSpinal Disord Tech,2008,21(2):112-115.
[20]许伏龙,朱青安,王吉星,等.关节突关节倾斜度与退行性腰椎滑脱的相关性研究[J].实用骨科杂志,2017,23(8):707-710;732.
[21]郭马超,鲁世保,孔超.小关节角度和不对称性在L4~5退变性滑脱发生中的作用[J].实用骨科杂志,2018,24(7):584-588.
[22]Reid IR.Relationships among body mass,its components,and bone[J].Bone,2002,31(5):547-555.
[23]Kalichman L,Guermazi A,Li L,et al.Association between age,sex,BMI and CT-evaluated spinal degeneration features[J].J Back Musculoskelet Rehabil,2009,22(4):189-195.
[24]Rankine JJ,Dickson RA.Unilateral spondylolysis and the presence of facet joint tropism[J].Spine(Phila Pa 1976),2010,35(21):1111-1114.