第4腰椎下关节突距第5腰椎峡部垂直距离的X线研究  

X-ray study of the perpendicular distance between the inferior articular process of lumbar 4 and the pars interarticularis of lumbar 5

作　　者：高山松 王虎虎 高智[1] 张军武[1] GAO Shan-song;WANG Hu-hu;GAO Zhi;ZHANG Jun-wu(No.2 Orthopaedics Department,Yulin No.2 Hospital,Yulin 719000,China)

机构地区：[1]榆林市第二医院骨二科,陕西榆林719000

出　　处：《临床医学研究与实践》2018年第33期57-59,共3页Clinical Research and Practice

摘　　要：目的探讨第4腰椎(L_4)下关节突距第5腰椎(L_5)峡部的距离与L_5双侧峡部裂及L_5双侧峡部裂性滑脱的关系及临床意义。方法选取我院1998年8月至2015年5月收治的腰椎病患者77例,将其分为A组(无L_5峡部裂及滑脱组)17例,B组(L_5双侧单纯峡部裂组)22例,C组(L_5双侧峡部裂性滑脱组)38例。分别在腰椎左、右45°前斜位X线片上用Digimizer测量软件测量三组L_4下关突顶点至L_5峡部的垂直距离(d)以及L_4椎体前后高度均值(h),再用d/h作为L_4下关突至L_5峡部的垂直距离。比较三组患者平均年龄及腰椎同侧d/h值。结果 A组和C组的平均年龄均显著大于B组,差异具有统计学意义(P<0.05);A组和C组的平均年龄比较,差异无统计学意义(P>0.05);右前斜位X线片上A、B、C组的d/h分别为(0.117±0.050)、(0.056±0.035)、(0.023±0.030),左前斜位上A、B、C组的d/h分别为(0.121±0.040)、(0.052±0.033)、(0.022±0.031),A组的d/h均显著大于B、C组,差异有统计学意义(P<0.01);B组的d/h均显著大于C组,差异有统计学意义(P<0.01)。结论 L_4下关节突距L_5峡部垂直距离越短越容易发生L_5峡部裂并进而发展为峡部裂性滑脱,可通过对该距离的测量来评估L_5峡部裂的风险及预测L_5峡部裂是否进展为滑脱。Objective To explore the relationship of the perpendicular distance between the inferior articular process oflumbar4 （L4） and the pars interarticularis of lumbar5 （L5） with bilateral spondylolysis ofL5 and bilateral isthmicspondylolisthesis ofL5 and its clinical significance. Methods From August 1998 to May 2015, 77 patients with lumbardisease admitted in our hospital were selected and divided into groupA （n=17, without spondylolysis ofL5 or isthmicspondylolisthesis ofL5）, groupB （n =22, with bilateral spondylolysis ofL5） and groupC （n =38, with bilateral isthmicspondylolisthesis ofL5）. The Digimizer measurement software was used to measure the perpendicular distance from the peakof the inferior articular process ofL4 to the pars interarticularis ofL5 （d） and the average value of height before and after （L4vertebral body （h） on the left and right 45毅 anterior oblique X-ray films of the lumbar spine. The average ages of patients andthe ipsilateral d/h values of the lumbar spine were compared among the three groups. Results The auerage ages of the groupA and groupC were significantly higher than that of the group B, and the differences were statistically significant （P〈0.05）.There was no significant difference in the average age between the group A and the groupC（P〉0.05）. The d/h of the group A,B and C on the right anterior oblique X-ray films were （0.117依0.050）, （0.056依0.035）, （0.023依0.030）, which on the left anterioroblique X-ray films were （0.121依0.040）, （0.052依0.033）, （0.022依0.031）, the d/h of the group A was significantly greater thanthat of the group B and C, and the differences were statistically significant （P〈0.01）. The d/h of the groupB was significantlygreater than that of the group C, and the difference was statistically significant （P〈0.01）. Conclusion The shorter theperpendicular distance of the inferior articular process ofL4 to the pars interarticularis ofL5 is, the more the spondylolysis ofL and then the ist

关 键 词：腰椎 脊椎滑脱 X线 下关节突 峡部裂 

分 类 号：R681.5[医药卫生—骨科学]