老年女性骨质疏松椎体压缩骨折与下腰椎多裂肌 椎间盘退变及腰椎-骨盆参数的关系  

The relationship of osteoporotic vertebral body compression fracture with the degeneration of multifidus muscle and intervertebral disc in lower lumbar spine and the lumbar-pelvic parameters in elderly women

作　　者：方明[1] 陆建猛[1] 王兴武[1] 韦勇力[1] 陆旻昊 Fang Ming;Lu Jianmeng;Wang Xingwu;Wei Yongli;Lu Minhao(Department of Orthopaedics,the Affiliated Hospital of Medical School of Ningbo University,Ningbo 315000,China)

机构地区：[1]宁波大学医学院附属医院骨科,315000

出　　处：《中华老年医学杂志》2021年第5期628-631,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨老年女性骨质疏松骨折与下腰椎多裂肌、椎间盘退变及腰椎-骨盆参数的关系。方法回顾性分析108例老年女性骨质疏松患者的临床资料,根据有无椎体骨折分为骨折组和对照组,收集两组患者的年龄、体质指数(BMI)、骨密度(BMD),应用站立位腰椎侧位X片测量腰椎骨盆入射角(PI)、骨盆倾斜角(PT)、下腰椎前凸角(LLL)、骶骨倾斜角(SS),应用腰椎MRI测量两组患者L3~S1椎间盘及多裂肌退变程度,比较两组患者指标的差异。结果两组患者年龄、BMI、BMD比较差异均无统计学意义(均P>0.05),具有可比性。骨折组L_(3~4)、L_(4~5)椎间盘退变程度高于对照组,差异有统计学意义(Z=-4.656、-2.675,P=0.000、0.007),L_(5)~S_(1)椎间盘退变两组比较差异无统计学意义(Z=-1.784,P=0.075)。骨折组L_(3~4)、L_(4~5)多裂肌退变程度高于对照组,差异有统计学意义(Z=-3.248、-4.073,P=0.001、0.000),L_(5)~S_(1)多裂肌退变两组比较差异无统计学意义(Z=-1.096,P=0.282)。骨折组和对照组PI、PT、SS、LLL差异无统计学意义(t=1.162、0.827、-0.082、-0.677,P=0.248、0.410、0.935、0.500)。结论L_(3~4)、L_(4~5)椎间盘及多裂肌退变与老年女性骨质疏松骨折的发生相关。Objective To investigate the relationship of osteoporotic vertebral body compression fracture(OVCF)with multifidus muscle and intervertebral disc degeneration in the lower lumbar spine and the lumbar-pelvic parameters in elderly women.Methods Clinical data of a total of 108 elderly women with osteoporosis were retrospectively analyzed.They were divided into the fracture group(n=56)and the control group(n=52)according to the presence of vertebral body compression fractures.Age,body mass index(BMI)and bone mineral density(BMD)were collected in two groups.The angle of pelvic incidence(PI),angle of pelvic tilt(PT),low lumbar lordosis(LLL)and sacral slope(SS)were measured by the standing lumbar lateral X-ray photography.The degree of degeneration of intervertebral disc L_(3)-S_(1) and multifidus muscle were detected by using the lumbar MRI.These parameters were compared between the two groups.Results The age,BMI and BMD had no significant difference between the two groups(P>0.05).The degree of intervertebral disc degeneration of L_(3)-L_(4) and L_(4)-L_(5) was statistically significant higher in the fracture group than in the control group(Z=-4.656 and-2.675,P=0.000 and 0.007),while the degree of intervertebral disc degeneration of L5-S1 had no statistically significant difference between the two groups(Z=-1.784,P=0.075).There were statistically significant higher multifidus muscle degeneration of L_(3)-L_(4) and L_(4)-L_(5) in the fracture group than in the control group(Z=-3.248 and-4.073,P=0.001 and 0.000),while no significant difference between the two groups in multifidus muscle degeneration of L_(5)-S_(1)(Z=-1.096,P=0.282).No statistically significant differences were found in PI,PT,SS and LLL between the two groups(t=1.162,0.827,-0.082 and-0.677,P=0.248,0.410,0.935 and 0.500).Conclusions The degeneration of intervertebral disc and multifidus muscle of L_(3)-L_(4) and L_(4)-L_(5) is positively correlated with OVCF in elderly women.

关 键 词：骨质疏松 骨折 压缩性 椎间盘退变 

分 类 号：R580[医药卫生—内分泌] R683[医药卫生—内科学]