青年下腰痛患者腰椎生理曲度与腰椎间盘Pfirrmann分级的相关性研究  

MRI assessment of the correlation between lumbar physiological curvature and Pfirrmann grading of lumbar intervertebral disc in young patients

作　　者：唐翎[1] 仲建全[1] 巫恒平 郭欢[1] TANG Ling;ZHONG Jianquan;WU Hengping;GUO Huan(Department of Radiology,the First People's Hospital of Zigong,Zigong,Sichuan Province 643000,China)

机构地区：[1]自贡市第一人民医院放射科,四川自贡643000

出　　处：《实用放射学杂志》2018年第12期1912-1914,1928,共4页Journal of Practical Radiology

摘　　要：目的探讨青年下腰痛患者腰椎生理曲度与腰椎间盘Pfirrmann分级的相关性。方法回顾性分析111例因下腰痛行腰椎MRI检查的青年患者。由2名放射诊断医师对MRI图像进行分析,观察腰椎生理曲度与腰椎间盘退行性改变Pfirrmann分级的关系,并对统计结果进行χ^2检验。结果腰椎生理曲度变直组60例患者共300个椎间盘纳入最终分析,其中Pfirrmann分级Ⅰ~Ⅱ级退变209个(70%),Ⅲ级退变45个(15%),IV级退变35个(11%),V级退变111个(4%)。腰椎生理曲度正常组51例患者共255个椎间盘纳入最终分析,其中Pfirrmann分级I~Ⅱ级退变212个(83%),llI级退变22个(9%),Ⅳ级退变19个(7%),V级退变2个(1%)。腰椎生理曲度变直与腰椎生理曲度正常组间,不同退变分级间均存在统计学差异(P<O.05)。在腰椎生理曲度变直组中,I~Ⅱ级退变所占比例低于腰椎生理曲度正常组,而Ⅲ级、Ⅳ级和V级退变所占比例高于后者。结论腰椎生理曲度变直是青年下腰痛患者腰椎间盘发生退行性改变的重要征象,腰椎生理曲度变直容易导致青年患者发生下位椎间盘的PfirrmannⅣ~V级退变。Objective To investigate the correlation between lumbar physiological curvature and Pfirrmann grading of lumbar intervertebral disc in young patients with lower lumbar pain.Methods 111cases with lower lumbar pain were analyzed retrospectively by lumbar MRI examination.The MRI image was reviewed by two radiologists,and the degree of lumbar physiological curvature and lumbar disc degeneration were observed.Chi square test was applied to the statistical results.Results Final analysis was performed on 300discs in 60cases of patients with lumbar physiological curvature straightening.Among them,209were grade Ⅰ -Ⅱ {70%),45grade Ⅲ (15%),35grade IV(11%)and 11grade V (4%)in Pfirrmann grading.In total of 255discs of 51cases with normal physiological curvature of the spine,there were 212(83%)of Pfirrmann grade Ⅰ -Ⅱ ,22of grade Ⅲ(9%),19of grade IV (7%)and 2of grade V (1%).There was statistical difference between the lumbar physiological curvature straightening and the normal lumbar physiological curvature group (P<0.05).The proportions of degeneration of Ⅰ-Ⅱin the lumbar physiological curvature group was lower than that in normal lumbar curvature group,while the proportions of grade Ⅲ,IV andV degeneration in the lumbar physiological curvature group were higher than that in normal lumbar curvature group.Conclusion Stratification lumbar physiologic curvature is an important factor for lumbar disc degeneration and easy to cause Pfirrmann grade IV-V degeneration in young patients.

关 键 词：青年 腰椎曲度 Pfirrmann分级 磁共振成像 

分 类 号：R681.53[医药卫生—骨科学] R445.2[医药卫生—外科学]