测量L4倾斜角和小关节角对L4椎体退行性滑脱症的预测价值  

The predictive value of L4 inclination angle and facet joint angle for L4 degenerative spondylolisthesis

作　　者：李晖[1] LI Hui(The Third Department of Orthopaedics,Nanyang Central Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院骨三科,河南南阳473000

出　　处：《颈腰痛杂志》2021年第1期47-51,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：宁夏回族自治区自然科学基金(编号:NZ16212)。

摘　　要：目的探讨L 4倾斜角(L_(4) inclination angle,L_(4)IA)、小关节角(facet joint angle,FJA)与L_(4)退行性椎体滑脱(degenerative lumbar spondylolisthesis,DLS)的相关性。方法将2016年7月-2019年3月本院骨科收治的90例L_(4) DLS患者纳入DLS组,另将同期就诊的90例无椎体滑脱的腰背痛患者纳入对照组。对比两组患者的L_(4)IA、FJA、椎旁肌横截面积、L_(4-5)椎间盘Pfirrmann分级、小关节(facet joint,FJ)退变分级等参数;同时对DLS发生的相关预测因素进行Logistic回归分析。结果两组L_(4)IA、FJA、FJ退变分级比较,差异均有统计学意义(P<0.05);而性别、年龄、体重指数和椎间盘Pfirrmann分级、椎旁肌横截面积等组间差异均无统计学意义(P>0.05)。Logistic回归分析显示,L_(4)IA、FJA和FJ退变分级均为L_(4)椎体滑脱的独立预测因素(P<0.05);经ROC曲线分析,L_(4)IA的临界值为11.15°,FJA的临界值为60.19°。结论L_(4)IA、FJA对L_(4)椎体滑脱有显著影响,其中L_(4)IA>11.15°、FJA>60.19°的患者更易发生L_(4)椎体滑脱。Objective To investigate the correlation between L_(4) inclination angle(L_(4)IA),facet joint angle(FJA)and L_(4) degenerative lumbar spondylolisthesis(DLS).Methods From July 2016 to March 2019,90 patients with L_(4) DLS admitted to the Department of Orthopaedics of our hospital were included in the DLS group,and 90 patients with low back pain without spondylolisthesis were included in the control group.The parameters of L_(4)IA,FJA,cross-sectional area of paravertebral muscles,Pfirrmann and FJ of L_(4-5)intervertebral disc were compared between the two groups,and Logistic regression analysis was carried out to predict the occurrence of DLS.Results There were significant differences in L_(4)IA,FJA and FJ grades between the two groups(P<0.05),but there were no significant differences in gender,age,BMI,Pfirrmann grade of intervertebral disc and cross-sectional area of paravertebral muscle between the two groups(P>0.05).Logistic regression analysis showed that L_(4)IA,FJA and FJ grades were independent predictors of L_(4) spondylolisthesis(P<0.05).By ROC curve analysis,the critical value of L_(4)IA was 11.15°and FJA was 60.19°.Conclusion L_(4)IA and FJA have significant effects on L 4 spondylolisthesis,and patients with L_(4)IA>11.15°and FJA>60.19°are more likely to have L_(4) spondylolisthesis.

关 键 词：退行性腰椎滑脱症 L_(4)倾斜角 小关节角 腰背痛 

分 类 号：R681.5[医药卫生—骨科学]