青少年特发性脊柱侧凸结构性腰弯患者腰椎关节突关节角的变化及其意义  

Comparison of the orientation of the lumbar facet joints between adolescent idiopathic lumbar scoliosis and normal adolescent subjects

作　　者：俞杨[1] 殷刚[1] 邱勇[1] 王斌[1] 朱锋[1] 孙光权[1] 

机构地区：[1]南京大学附属鼓楼医院脊柱外科,江苏省南京市210008

出　　处：《中国脊柱脊髓杂志》2008年第11期815-819,共5页Chinese Journal of Spine and Spinal Cord

基　　金：江苏省"六大人才高峰"第四批资助项目(编号:07-B-027)

摘　　要：目的：观察青少年特发性脊柱侧凸（AIS）结构性腰弯患者腰椎关节突关节角角度与正常腰椎关节突关节角角度的差异，探讨AIS患者后期出现腰背痛和腰椎退行性疾病高发的可能原因。方法：结构性腰弯的AIS患者21例（AIS组），非脊柱畸形的青少年20例（对照组）。AIS组中男3例，女18例，年龄12～17岁，平均14．4岁，腰弯Cobb角38°～115°平均54．2°。对照组男8例，女12例，年龄10-19岁，平均为15．2岁。均采用螺旋CT连续扫描T12～S1，通过PACS Client软件测量所有受试者腰椎关节突关节角和结构性腰弯AIS患者腰椎RAsag角。将对照组左、右侧腰椎关节突关节角角度进行配对t检验；对AIS组患者凹侧、凸侧的腰椎关节突关节角角度进行配对t检验，并对凹侧与凸侧腰椎关节突关节角角度差和Cobb角、相应节段腰椎的RAsag角进行相关惟分析。结果：对照组双侧腰椎关节突关节角角度在所有节段未见显著性差异（P〉0．05），AIS组所有节段凹侧的腰椎关节突关节角角度明显大于凸侧（P〈0．05）；凹侧和凸侧的腰椎关节突关节角角度差与Cobb角、相应节段腰椎的RAsag角没有显著相关性（P〉0．05）。结论：结构性腰弯的AIS患者凹侧的腰椎关节突关节角度明显大于凸侧，这可能是该类患者后期凹侧腰椎关节突关节更易发生退行性病变的因素之一。Objective：To observe the difference of the orientation of the lumbar facet joints between adoles-cent idiopathic lumbar scoliosis and normal controls,and to explore the probable anatomical cause of the high incidences of back pain and lumbar degenerative diseases in adult idiopathic lumbar scoliosis patients. Method：21 AIS patients （3 males, 18 females,12-17 years old,Cobb angle 38°-115°） with structural lumbar curve and 20 normal controls（8 males,12 females,10-19 years old） who did not have spinal deformity were included in this study.Successive CT lumbar vertebras scanning of all subjects were obtained.The orientation of lumbar facet joints of all participants and lumbar vertebras RAsag angles of AIS patients were measured with the software of PACS Client.In control group,the orientation of bilateral lumbar facet joints were com- pared using paired-t test.ln AIS group,the orientation of concave and convex side facet joints were analyzed using paired-t test,linear correlations between the difference of bilateral facet joints and Cobb angel,as well as RAsag angle,were calculated using Pearson correlation coefficients.Result：In control group,no difference were found in bilateral orientation of lumbar facet joints.In AIS group,the orientation of lumbar facet joints in the concave side was lager than that in the convex side （P〈0.05）.There were no significant correlations between the difference of bilateral lumbar facet joints and Cobb angel,as well as RAsag angle（P〉0.05）.Conclusion：Present study suggests that lager angel of lumbar facet joints in the concave side may make AIS patients at higher risk to develop lumbar degeneration in later period.

关 键 词：脊柱侧凸 青少年 腰椎 关节突关节 

分 类 号：R682.3[医药卫生—骨科学]