退行性腰椎侧弯的X线平片分析  

The Imaging Features of Lumbar Degenerative De Novo Scoliosis

作　　者：赵新燕[1] 郭江辉[2] 

机构地区：[1]西北农林科技大学医院放射科,杨凌712100 [2]西北农林科技大学动物医学院,杨凌712100

出　　处：《临床放射学杂志》2014年第6期938-942,共5页Journal of Clinical Radiology

摘　　要：目的探讨退行性腰椎侧弯的影像学表现及相关临床意义。方法回顾性阅读1957例腰椎侧弯平片,其中887例确诊为退行性腰椎侧弯。阅读上述影像学资料,观察分析不同性别、不同年龄段腰椎侧弯的比率、方向、Cobb角角度、顶椎位置及所伴有的退行性改变等。并经R软件包,通过拟合线性模型采用t检验Cobb角在性别和不同年龄间的差异。结果确诊退行性腰椎侧弯887例,其中男性434例,女性453例。主要发生于50岁以上,左侧弯居多,顶椎位置多位于L2、3椎间隙,Cobb角最小13°,最大46°。以10岁为一年龄段(40≤年龄<50,50≤年龄<60,60≤年龄<70,70≤年龄<80,80≤年龄<90),经统计学分析,Cobb角在性别间分布差异极显著(t=98.853,P<0.01)且女性高于男性;Cobb角随着年龄的增加而升高,差异显著(t=21.214,P<0.05)。结论通过分析不同性别、不同年龄段退行性腰椎侧弯者的影像学表现及Cobb角在性别和年龄间的分布差异,对退行性腰椎侧弯的特性、诊断与鉴别诊断及指导临床治疗有重要价值。Objective To investigate the imaging findings and clinical manifestations of lumbar degenerative de novo scoliosis （LDDS）. Methods 887 patients （453 females and 434 males） with LDDS were reviewed. Females and males were divided into 5 groups according to age （ 40≤ age 〈50,50≤age 〈60,60≤age 〈 70 ,70 ≤ age 〈80,80≤age 〈90）. The imaging findings in different genders and ages, such as the proportion, curve direction, Cobb angle, apex vertebra position and possible degenerative changes of LDDS were analyzed. The difference of Cobb angle between genders and ages were an- alyzed using R software package. Results LDDS was mainly suffered by people aging more than 50 years old. LDDS showed mostly left curve direction and many apex vertebra positions locate in L2/3 intervertebral space. Cobb angle ranges from 13°to 46° combined with degenerative changes in centrum, intervertebral disc, and zygapophysial joints. There was significant difference of cobb angle distribution between genders （ t = 98. 853, P 〈 0.01 ）. Cobb angle was higher in females than in males. In addition, cobb angle increased with age increased（ t = 21. 214,P 〈 0.05 ）. Conclusion The imaging findings of LDDS with different genders and ages has great value in clinical assessment, diagnosis and differential diagnosis, which have guidance of clinical treatment.

关 键 词：退行性 腰椎侧弯 影像学表现 

分 类 号：R682.3[医药卫生—骨科学] R816.8[医药卫生—外科学]