腰椎间盘退变后椎体的变化及其临床意义  

The changes of the vertebral body in the lumbar disc degeneration and its clinical significance

作　　者：孟宪中[1] 孟宪国[1] 申勇[1] 李宝俊[1] 董玉昌[1] 张标[1] 

机构地区：[1]河北医科大学第三医院脊柱外科,河北050051

出　　处：《脊柱外科杂志》2006年第1期21-24,共4页Journal of Spinal Surgery

摘　　要：目的研究腰椎退变时椎体的形态和骨密度的变化规律,探讨其临床意义。方法选择对照组患者31例,腰椎退变组患者94例,通过应用计算机处理其X线片和MRI等影像学资料,测定L4,L5椎体的骨密度和测定腰椎椎体的周径和对角径、相对高度,相对矢状径及对角径等,同时观察MRI上椎体骨髓信号的改变。应用SPSS11.5对实验数据进行处理。结果①对照组L4及L5椎体指数在男女间比较差异无显著性(P>0.05)。提示X线侧位片上男、女L4及L5椎体的形态相似。②L4及L5椎体指数在对照组明显大于退变组,之间比较有显著性差异(P<0.05)。③L4及L5椎体相对高度在对照组均较退变组高,而椎体的上下矢状径对照组较退变组要小,对角距差别不大;比较具有统计学上的差异显著性(P<0.05)。④椎体骨密度测定结果显示两组间有显著差异性(P<0.05)。结论腰椎间盘退变后,椎体发生改变与否与椎间盘退变的程度成正相关。Objective To evaluate the changes of vertebral body and bone mineral density （BMD） in the lumbar disc degeneration, and to explore its clinical significance. Methods There were 31 cases in the control group and 94 cases in the lumbar degenerative group. Using the computer to deal with the X-ray and MR imaging materials, we chose to measure the vertebral height and the width of the body as well as diagonal conjugate and calculate the relative height, sngittal diameter and diagonal conjugate to evaluate the changes of the vertebral body. At the same time we chose to observe the signal changes of the bone marrow of the vertebral body by MRI, using SPSS 11.5 to deal with the statistical data. Results In the control group the vertebral index showed no difference between the male and the female （ P 〉0.05 ）, and lateral X-rays showed that the shapes of the body in the male and female were similar to the each other. There were significant differences between the two groups （ P 〈 0. 05 ） because the vertebral index of the control group was much larger than that of the degenerative group. There were significant differences in these two groups compared with the relative height, sagittal diameter and diagonal conjugate （ P 〈0.05）. The measuring results of BMD showed that there were significant differences between the two groups （ P 〈0.05）. Conclusion With the lumbar disc degeneration, whether the vertebral body could have a change or not, which has positive correlation with the degenerative degree.

关 键 词：腰椎 骨密度 椎间盘移位 椎管狭窄 

分 类 号：R681.533[医药卫生—骨科学]