腰椎小关节精确测量及其与腰椎管狭窄症的相关性研究  

Accurate measurement of lumbar facet orientation in patients with lumbar spinal stenosis syndrome

作　　者：闫广辉[1] 高春光[1] 李华[1] 索娜[1] 武佳奇[1] 魏巍[1] 靳宪辉[1] 张庆胜[1] 

机构地区：[1]河北医科大学附属哈励逊国际和平医院骨科,河北衡水053000

出　　处：《中国现代医学杂志》2015年第35期88-91,共4页China Journal of Modern Medicine

基　　金：2013年度河北省省级科技计划项目(No:132777152)

摘　　要：目的 精确测量和分析腰椎小关节方向性与腰椎管狭窄症（LSSS）的相关性.方法 120例LSSS患者为观察组（LSSS组）,选取与LSSS组年龄、性别相匹配的100例患者作为对照组,其CT检查未见明显椎管狭窄.用CT终端机分别测量L3～S1椎间隙的远侧椎体上终板层面,测量腰椎小关节角、前内侧角、后外侧角.结果 ①LSSS组腰椎小关节角及前内侧角大于对照组（P＜0.05）,即LSSS组腰椎小关节,尤其前内侧部分更偏冠状位;后外侧角度两组比较差异无统计学意义（P＞0.05）.②两组腰椎小关节角、后外侧角L3～4到L5～S1节段逐渐增大（P＜0.05）;而前内侧角L4～5节段最大,L.节段最小（P＜0.05）.结论 腰椎小关节前内侧部分增生内聚是引起腰椎管狭窄的重要原因;腰椎小关节角度精确测量为临床腰后路减腰椎小关节保留程度提供参考价值.[Objective] To investigate the relationship of accurate lumbar facet orientation with lumbar spinal stenosis syndrome （LSSS）. [Methods] The 120 patients with LSSS were included in the observation group and 100 patients without LSSS were in the control group which was similar with the observation group in gender and age. All measurements were performed using bone window CT images. The plane was selected aligned parallel to the vertebral up endplate. The lumbar facet angle, anteriomedialis angle and posteriolateralis angle of the lumbar facet were measured in L3-S1. [Results] ① The lumbar facet angles and anteriomedialis angles of the LSSS group were bigger than those of the control group （P 〈 0.05）, the lumbar facets （especially the anteriomedialis part） were more coronal. The posteIiolateralis angles were not different between both groups （P 〉 0.05）. ② The lumbar facet angles and posteriolateralis angles gradually increased from L3-L4 to L5-S1 in all the subjects （P〈 0.05）; while the anteriomedialis angle of L4-L5 was the biggest, that of L3-L4 was the smallest （P 〈 0.05）. [Conclusions] Proliferation of the anterior medial part of the lumbar facet joint is an important cause of lumbar spinal stenosis. Accurate measurement of lumbar facet joint angle can provide a reference for the reserve of lumbar facet joint in the lumbar posterior decompression.

关 键 词：腰椎管狭窄症 腰椎小关节 前内侧角 后外侧角 

分 类 号：R681.53[医药卫生—骨科学]