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作 者:任东风[1] 侯树勋[1] 吴文闻[1] 商卫林[1] 吴叶[1]
机构地区:[1]解放军总医院第一附属医院骨科全军骨科研究所,北京100048
出 处:《中国疼痛医学杂志》2011年第3期131-133,136,共4页Chinese Journal of Pain Medicine
摘 要:目的:分析腰椎退行性疾病患者MR I上L4,5小关节积液和X线上矢状位腰椎动力位不稳的相关性。方法:2006年1月~2009年12月在我院行腰椎MR I和站立位过伸过屈X线检查的98例L4,5腰椎退行性疾病患者,在轴状位MR I T2像上测量L4,5小关节积液和站立位过伸过屈侧位X线片影像评估腰椎不稳。记录L4,5小关节积液大小和动态不稳滑移参数。统计学分析是否小关节积液与腰椎动态不稳存在关系。结果:98例患者中,33例在站立位过伸过屈位X线片出现L4,5动态不稳,65例没有出现动态不稳。24例(73%)动态不稳患者出现小关节积液,平均滑移参数是11.6%(0%~32%),平均小关节积液数值是1.98mm(0~6.28mm)。22例(34%)没有出现动态不稳患者例出现小关节积液,平均小关节积液数值是1.02mm(0~4.36mm)。小关节积液大小与腰椎动态不稳存在联系,并有统计学意义(P<0.05)。结论:在MR I上出现小关节积液信号提示腰椎退行性动态不稳,小关节积液量与腰椎动态不稳正相关。Objective:The purpose of this study was to analyze the association between lumbar facet fluid on MRI and sagittal dynamic instability on standing lateral flexion-extension(SLFE) in patients with degenerative disease at L4~5.Methods:MRI and SLFE films of 98 patients seen at our institution for the treatment of degenerative lumbar disease at L4~5 between 2006,1 and 2009,12.The facet fluid on axial T2 MRI images,dynamic instability on SLFE films through the L4~5 facets were analyzed.The presence of facet effusions,anterior sagittal plane translation were recorded.The data were analyzed to determine if there was a significant association between the presence of lumbar dynamic instability and facet effusion.Results:Ninty-eight patients were included in the study,there were 65 patients without lumbar dynamic instability(LDI) and 33 with LDI on SLFE films at L4,5.24(73%)patients with LDI have facet fluid on the MRI,the mean facet fluid size and percent anterior slip of L4 on L5 was 1.98mm(range,0~6.28mm) and 11.6%(range,0%~32%),respectively,average facet osteoarthritis grade was 2.23.22(34%)patients without LDI have facet fluid,the mean percent anterior slip of L4 on L5 was 1.02mm(range,0~4.36mm).The amount of facet fluid detected on MRI have a positive correlation to sagittal dynamic instability detected on the lateral flexion radiograph(P0.05).Conclusions:A clinically measurable facet effusion in MRI suggests the lumbar degenerative dynamic instability.There is a postive association between the facet fluid size and the amount of radiographic lumbar dynamic instability.
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