中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (35): 6563-6566.doi: 10.3969/j.issn.1673-8225.2011.35.024

• 骨与关节损伤基础实验 basic experiments of bone and joint injury • 上一篇    下一篇

腰椎小关节方向性与腰椎间盘突出症

闫广辉1,2，徐宝山1，夏  群1，谭清实1，王文格3，杨海平3   

  1. 1天津市天津医院脊柱外科，天津市  300211
    2哈励逊国际和平医院骨病科，河北省衡水市 053000
    3河北工程大学附属医院骨一科，河北省邯郸市056002
  • 收稿日期:2011-03-10 修回日期:2011-06-20 出版日期:2011-08-27 发布日期:2011-08-27
  • 通讯作者: 徐宝山，主任医师，天津市天津医院脊柱外科，天津市300211 xubshn@yahoo.com.cn
  • 作者简介:闫广辉★，男，1982年生，河北省邯郸市人，汉族，2010年天津医科大学研究生院毕业，硕士，医师，主要从事脊柱外科相关研究。
  • 基金资助:

    人力资源和社会保障部留学人员科技择优资助项目(人发2001-33号)；天津市卫生局科技攻关课题(07KG1)。

Lumbar facet orientation in patients with lumbar disc herniation

Yan Guang-hui1,2, Xu Bao-shan1, Xia Qun1, Tan Qing-shi1, Wang Wen-ge3, Yang Hai-ping3   

  1. 1Department of Spinal Surgery, Tianjin Hospital, Tianjin  300211, China
    2Department of Bone Disease, Harrison International Hospital, Hengshui  053000,  Hebei Province, China
    3Department of Orthopedics, Affiliated Hospital of Hebei University of Engineering, Handan  056002, Hebei Province, China
  • Received:2011-03-10 Revised:2011-06-20 Online:2011-08-27 Published:2011-08-27
  • Contact: Xu Bao-shan, Chief physician, Department of Spinal Surgery, Tianjin Hospital, Tianjin 300211, China xubshn@yahoo.com.cn
  • About author:Yan Guang-hui★, Master, Physician, Department of Spinal Surgery, Tianjin Hospital, Tianjin 300211, China; Department of Bone Disease, Harrison International Hospital, Hengshui 053000, Hebei Province, China
  • Supported by:

    Merit-based Technology Fund for Overseas Students, Ministry of Human Resources and Social Security, No. 2001-33*; Science and Technology Tackle Key Project of Tianjin Health Bureau, No. 07KG1*

PDF

371

被引次数

20

摘要：

背景：腰椎小关节及其对称性与腰椎间盘突出之间是否存在关系，文献报道争议很大。
目的：测量分析腰椎小关节方向性与腰椎间盘突出的关系。
方法：收集因腰腿痛行CT检查的169例患者，L4/5 腰椎间盘突出35例，L5/S1腰椎间盘突出67例，无间盘突出对照组67例。在CT终端机上选取L3~S1椎间隙的远侧椎体上终板层面，测量3个节段的腰椎小关节角。
结果与结论：① L4/5和L5/S1腰椎间盘突出组L3/4、L4/5、L5/S1每个节段腰椎小关节角左侧均大于右侧(P < 0.05)；各组小关节前内侧角和后外侧角两侧相比差异均无显著性意义(P > 0.05)。②各节段腰椎小关节角、前内侧角、后外侧角3组之间比较没有显著性差异(P > 0.05)。③各组腰椎小关节角、后外侧角自L3/4至L5/S1节段均逐渐增大(P < 0.05)；而前内侧角L4/5节段最大，L3/4节段最小(P < 0.05)。提示腰椎间盘突出与腰椎小关节角左右侧不相等有关；腰椎小关节角和后外侧角自L3/4至L5/S1逐渐更偏向冠状位，而内侧角在L4/5节段更偏冠状位，可能与腰椎管狭窄的发病有关。

关键词: 腰椎小关节, 腰椎间盘突出, 腰椎管狭窄, 前内侧角, 后外侧角

Abstract:

BACKGROUND: The relationship between lumbar facet orientation and lumbar disc herniation (LDH) is the one of the research focus in the spine. But that does not reach consensus.
OBJECTIVE: To investigate the relationship of lumbar facet orientation to LDH.
METHODS: A total of 169 backleg pain patients were examined with CT, which were in three groups. L4/5 LDH was 35 subjects in group A, L5/S1 LDH was 67 subjects in group B and the other 67 subjects (control group) were normal in CT examination in group C. All measurements were performed using bone window CT images. The plane was selected aligned parallel to the vertebral up endplate. The lumbar facet was separated in anteriomedialis-angle and posteriolateralis-angle based on the most depressed of the lumbar facet. The three angles between left and right in one group and in the three groups were compared respectively.
RESULTS AND CONCLUSION: ①For groups A and B, the left angle was bigger than the right in the lumbar facet angle (P < 0.05); while the control group had no difference between both sides (P > 0.05); and there was no difference between the both sides for three groups in anteriomedialis-angle and posteriolateralis-angle (P > 0.05). ②Difference in lumbar facet angle, anteriomedialis-angle and posteriolateralis-angle was not found in the three groups (P > 0.05). ③The lumbar facet angle and posteriolateralis-angle were gradually increased from L3/4 ,L4/5 and L5/S1 in all subjects (P > 0.05); while the L4/5 was the biggest, the L3/4 was the smallest for the anteriomedialis-angle (P > 0.05). There are some associations between lumbar intervertebral disc herniation and lumbar facet angle asymmetry. The lumbar facet angle and posteriolateralis-angle is more and more coronal from L3/4, L4/5 and L5/S1 in all subjects and the anteriomedialis-angle is more coronal in L4/5, which may cause lumbar spinal stenosis.

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