不同类型腰骶移行椎与椎间盘退变Pfirrmann分级的相关研究  

Correlation study between different types of lumbosacral transitional vertebrae and Pfirrmann grading of intervertebral disc degeneration

作　　者：王振波 邹月芬[1] 时寅 金鑫 WANG Zhenbol;ZOU Yuefen;SHI Yin;JIN Xin(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Rad iology,Yangzhou Hospital of Traditional Chinese Medicine,Yangzhou,Jiangsu Province 225002,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029 [2]扬州市中医院放射科,江苏扬州225002

出　　处：《实用放射学杂志》2021年第11期1874-1876,1888,共4页Journal of Practical Radiology

摘　　要：目的确定不同类型腰骶移行椎(LSTV)与椎间盘退变Pfirrmann分级之间的关系。方法回顾性分析病例组271例LSTV和对照组273例非LSTV均伴有下腰痛患者的所有临床资料。观察最下面2个腰椎间盘退变Pfirrmann分级特点,并与对照组比较。同时,将对照组L5~S1椎间盘与病例组上位椎间盘的Pfirrmann分级作比较。结果对照组中L5~S1中重度退变(Pfirrmann 4~5级27.11%),而病例组中移行椎间盘较少退变(Pfirrmann 4~5级6.64%)。病例组中上位椎间盘的退变(Pfirrmann 4~5级28.41%)比对照组L4~L5(Pfirrmann 4~5级18.68%)更严重;亚组中,3型(Pfirrmann 4~5级36.67%)和4型(Pfirrmann 4~5级41.18%)退变最重。椎间盘退变的严重程度Pfirrmann分级与LSTV的类型有相关性。对照组中L5~S1退变的程度与病例组中上位椎间盘退变的程度相似。结论不同类型LSTV机械连接的增加,保护了移行椎间盘,使得上位椎间盘提早发生退变;较高类型LSTV的上位椎间盘退变更重。Objective To determine the relationship between different types of lumbosacral transitional vertebrae(LSTV)and Pfirrmann grading of intervertebral disc degeneration.Methods All clinical data were 271 subjects with LSTV in the case group and 273 subjects with non-LSTV in the control group,which were all with symptoms of low back pain.All data was retrospectively analyzed.The Pfirrmann grading characteristics of the last two lumbar intervertebral disc degeneration were observed and compared with the case-control.group.Meanwhile,the Pfirrmann grading of L5-S1 discs in the control group was compared with that of the adjacent cephalad segments in the case group.Results Moderate to severe degeneration(Pfirrmann 4-5 grade 27.11%)was observed at L5-S1 in the control.group,while less degeneration(Pfirrmann 4-5 grade 6.64%)was observed at the transitional intervertebral level in the case group.The degeneration(Pfirrmann 4-5 grade 28.41%)of the adjacent cephalad segments in the case group was more serious than that in.the control group at L4-L5 discs(Pfirrmann 4-5 grade 18.68%).In the subgroup,type 3(Pfirrmann 4-5 grade 36.67%)and type 4(Pfirrmann 4-5 grade 41.18%)had the severest degeneration.The severity of disc degeneration using the Pfirrmann grading had significant correlations with the type of LSTV.The degree of degeneration at L5-S1 in the control group was similar with that in the case group.Conclusion The increasing of mechanical connection between different types of LSTV protects the transitional intervertebral disc and causes the degeneration of the adjacent cephalad segments earlier.More severe degeneration of the adjacent cephalad segments is appeared in the higher types of LSTV.

关 键 词：椎间盘退变 Pfirrmann分级 腰骶移行椎 

分 类 号：R681.53[医药卫生—骨科学] R814.4[医药卫生—外科学]