腰椎小关节方向和骨性关节炎分级与侧隐窝狭窄症的关系  

The relationship between the leteral facet orientation,the degree of facet arthritis and the lateral recess stenosis

作　　者：顾树明[1] 张彦东[1] 肖京[1] 陈京峰[1] 李显[1] 

机构地区：[1]中国中医科学院西苑医院骨科,北京100091

出　　处：《中国医刊》2015年第1期43-45,共3页Chinese Journal of Medicine

摘　　要：目的：探讨腰椎小关节方向、骨性关节炎分级与腰椎侧隐窝狭窄症的关系。方法随机抽取60例腰椎侧隐窝狭窄症患者,测量腰椎双侧小关节角度、小关节骨性关节炎影像学分级,侧隐窝的骨性和纤维组织矢状径、横径。结果 L4-L5测量结果为（50±8.5）°,L5-S1为（37±10.6）°,其中两侧小关节角不对称,角度相差10°以上者有45例,腰椎小关节角度增大且双侧不对称者骨性关节炎发生率高达75%；小关节骨性关节炎分级,0级1例,1级9例,2级35例,3级15例,2、3级骨性关节炎患者侧隐窝狭窄症发生率达82.3%；经椎间盘平面侧隐窝矢状径为（2.5±0.7）mm,椎体后缘至上关节突间矢状径为（4.2±0.5）mm,横径为（5.25±0.8）mm。结论腰椎小关节的角度增大和不对称引起小关节骨性关节炎,进一步增加了腰椎侧隐窝狭窄症发生率。Objective To investigate the relationship between the leteral facet orientation,the degree of facet arthritis and the lateral recess stenosis. Method The MSCT axial images of 60 patients aged 38-81years with lateral recess stenosis. The facet orientation was evaluated, grades of FJOA were evaluated by 4-grade scale on CT images at L4 -L5 and L5 -S1 . The sagetal and transverse diameters of lateral recess also were evaluated. Result The orientation at L4 -L5 is （50±8. 5）°,L5 -S1（37±10. 6）°,45 of 60 cases are asymmetric. There are 1 case in grade 0,9 cases in grade 1,35 cases in grade 2,15 cases in grade 3,82. 3% of 60 cases have severe facet arthritis. The transverse di-ameter is （2. 5±0. 7）mm at intervertebral level. The sagital diameter is （5. 25±0. 8）mm. Conclusion The orienta-tion and asymmetry of the lateral facet may be the reason of facet arthritis. The arthritis take place with lateral recess stenosis.

关 键 词：腰椎 小关节 骨性关节炎 侧隐窝狭窄症 

分 类 号：R681.5[医药卫生—骨科学]