关节突关节横截面积与退行性颈椎滑脱的关系  

Relationship between facet joint cross-sectional area and degenerative cervical spondylolisthesis

作　　者：李志军[1] 丁韶龙[1] 周强 LI Zhi-jun;DING Shao-long;ZHOU Qiang(Department of Joint Surgery,Sanmenxia Central Hospital of Henan Province,Sanmenxia,Henan,472000,China)

机构地区：[1]河南省三门峡市中心医院关节外科,河南三门峡472000

出　　处：《颈腰痛杂志》2022年第6期794-797,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨关节突关节横截面积与退行性颈椎滑脱(degenerative cervical spondylolisthesis,DCS)的关系。方法选择2017年1月~2020年9月在本院就诊的207例颈椎病患者,采用MRI检测两侧关节突总截面积(total facet area,TFA)、小关节不对称因子(facet asymmetry factor,FAF),在X线片上是否存在DCS,观察TFA、FAF与DCS的相关性。结果C_(3)椎体前滑脱28例,后滑脱13例,无滑脱166例;C_(3)椎体前滑脱和后滑脱患者的年龄、TFA均高于无滑脱者(P<0.05),前滑脱患者FAF、FAF≥25%比例均高于后滑脱和无滑脱(P<0.05)。相关性分析显示,C_(3)椎体TFA与年龄呈正相关(r=0.403,P<0.001)。C_(4)椎体前滑脱29例,后滑脱14例,无滑脱164例;前滑脱患者的年龄、TFA、FAF及FAF≥25%均高于无滑脱者(P<0.05);C_(4)椎体TFA与年龄呈显著正相关(r=0.387,P<0.05)。多因素分析显示,年龄和FAF与前滑脱显著相关(P<0.05);TFA与C_(3)椎体前滑脱和后滑脱均相关(P<0.05),与C_(4)椎体前滑脱无显著相关性(P>0.05)。FAF≥25%与C_(3)和C_(4)椎体前滑脱均显著相关(P<0.05)。FAF≥25%预测C_(3)椎体前滑脱的符合度为83.09%,预测C_(4)椎体前滑脱的符合度为86.96%。结论颈部小关节不对称肥大提示可能存在单节段DCS,有助于临床进一步了解MRI征象和颈痛与神经根症状的联系。Objective To investigate the relationship between facet joint cross-sectional area and degenerative cervical spondylolisthesis(DCS).Methods From January 2017 to September 2020,207 patients with cervical spondylosis in our hospital were selected in this research.The total facet area(TFA)and facet asymmetry factor(FAF)on both sides were detected by MRI.The presence of DCS was detected by Taillard method on X-ray film,and the correlation between TFA,FAF and DCS was observed.Results C_(3) vertebral body anterior spondylolisthesis in 28 cases,posterior spondylolisthesis in 13 cases and no spondylolisthesis in 166 cases.The age and TFA of patients with C_(3) anterior and posterior spondylolisthesis were higher than those without spondylolisthesis(P<0.05).The proportion of FAF and FAF≥25%in patients with anterior spondylolisthesis was higher than those in patients with posterior spondylolisthesis and without spondylolisthesis(P<0.05).Correlation analysis showed that C_(3) TFA was positively correlated with age(r=0.403,P<0.001).C_(4) vertebral body anterior spondylolisthesis was observed in 29 cases,posterior spondylolisthesis in 14 cases and no spondylolisthesis in 164 cases.The age,TFA,FAF and FAF≥25%in patients with anterior spondylolisthesis were higher than those in patients without spondylolisthesis(P<0.05).C_(4) TFA was positively correlated with age(r=0.387,P<0.05).Multivariate analysis showed that age and FAF were significantly correlated with anterior spondylolisthesis(P<0.05).TFA was related to C_(3) anterior and posterior slippage(P<0.05),but was not correlated with C_(4) anterior spondylolisthesis(P>0.05).FAF≥25%was significantly related to C_(3) and C_(4) anterior slippage(P<0.05).According to the cut-off value of FAF of 25%,the coincidence degree of prediction of C_(3) anterior slippage was 83.09%,and that of C_(4) anterior slippage was 86.96%.Conclusion The presence of asymmetric hypertrophy of cervical facet joints suggests that single segment DCS may exist,which is helpful for clinicians to furthe

关 键 词：颈椎滑脱 关节突关节 横截面积 核磁共振 

分 类 号：R681.5[医药卫生—骨科学]