L_(5)S_(1)椎间盘突出与后关节突发育的关系  

Correlation between L5S1 intervertebral disc herniation and posterior facet process development

作　　者：何克云[1] 胡朝晖[1] 胡巍 罗同青[1] HE Ke-yun;HU Chaohui;HU Wei;LUO Tong-qing(Department of Spinal Surgery,Liuzhou People's Hospital,Liuzhou545006,Guangxi)

机构地区：[1]柳州市人民医院脊柱外科,广西柳州545006

出　　处：《中国矫形外科杂志》2024年第11期991-995,共5页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:81260274);广西卫健委自筹基金项目(编号:Z20170659)。

摘　　要：[目的]分析L_(5)S_(1)椎间盘突出与后关节突发育的关系。[方法]回顾性分析2017年—2020年本科收治的旁侧型椎间盘突出(lumbar disc herniation,LDH)(突出组)患者的临床资料,并收集107例腰椎MRI无LDH作为正常组,分别在MRI上测量两组L_(5)S_(1)关节突关节角度(facet joint,FJ)及两组邻近L_(4/5)FJ。计算左右侧FJ差值,差值>10°定义为双侧FJ不对称。采用单因素分析和多因素逻辑回归分析L_(5)S_(1)LDH的相关影响因素。[结果]共纳入突出组102例,正常组107例。单因素分析显示,两组年龄、性别、BMI、L_(4/5)(∠C)、L_(5)S_(1)(∠C)、L_(4/5)(∣∠α-∠β∣)、L_(4/5)不对称的差异均无统计学意义(P>0.05),但是,突出组L_(5)S_(1)(∣∠α-∠β∣)[(10.2±5.4)°vs(4.9±7.6)°,P<0.001]、L_(5)S_(1)不对称发生率[例(%),59(57.8)vs 14(13.0),P<0.001]、L_(4/5)与L_(5)S_(1)∠C差绝对值[(18.0±13.6)°vs(14.1±9.3)°,P=0.016]、L_(4/5)与L_(5)S_(1)∠α差绝对值[(12.0±8.2)°vs(8.7±5.9)°,P<0.001]、L_(4/5)与L_(5)S_(1)∠β差绝对值[(9.4±7.8)°vs(7.4±5.0)°,P=0.026]显著大于正常组。多因素逻辑回归分析显示,L_(5)S_(1)(∣∠α-∠β∣)(OR=1.245,P<0.001)、L_(4/5)与L_(5)S_(1)∠C差绝对值(OR=1.049,P<0.001)是L_(5)S_(1)旁侧型突出的独立危险因素。[结论]L_(5)S_(1)旁侧型LDH与L_(5)S_(1)(∣∠α-∠β∣)、L_(4/5)与L_(5)S_(1)∠C差绝对值具有相关性。[Objective]To analyze the relationship between L_(5)S_(1)lumbar disc herniation(LDH)and posterior facetjoint(FJ)develop⁃ment.[Methods]A retrospective analysis was conducted on the clinical data of lateral LDH patients who admitted to our department from 2017 to 2020,additionally,107 cases of lumbar spine MRI without LDH were collected as the normal group.The FJ angle of L_(5)S_(1)and adja⁃cent L_(4/5)were measured on MRI to calculate the difference in FJ between the left and right sides.A difference greater than 10°is defined as bilateral FJ asymmetry.Univariate comparison and multiple factor logistic regression were used to analyze the relevant influencing factors of L_(5)S_(1)LDH.[Results]A total of 102 cases were included in the LDH group,while 107 cases were in the normal group.As results of univariate comparison,there were not significant differences in terms of age,gender,BMI,L_(4/5)(∠C),L_(5)S_(1)(∠C),and L_(4/5)(∣∠α-∠β∣)and the differences in L_(4/5)asymmetry between the two groups(P>0.05),however,the LDH group proved significantly greater than the normal group regarding to L_(5)S_(1)(∣∠α-∠β∣)[(10.2±5.4)°vs(4.9±7.6)°,P<0.001],incidence of L_(5)S_(1)asymmetry[cases(%),59(57.8)vs 14(13.0),P<0.001],absolute dif⁃ference of∠C between L_(4/5)and L_(5)S_(1)[(18.0±13.6)°vs(14.1±9.3)°,P=0.016],absolute difference of∠αbetween L_(4/5)and L_(5)S_(1)[(12.0±8.2)°vs(8.7±5.9)°,P<0.001],absolute difference of∠βbetween L_(4/5)and L_(5)S_(1)[(9.4±7.8)°vs(7.4±5.0)°,P=0.026].Multivariate logistic regression analysis showed that the L_(5)S_(1)(∣∠α-∠β∣)(OR=1.245,P<0.001)and the absolute difference between L_(4/5)and L_(5)S_(1)∠C(OR=1.049,P<0.001)were the independent risk factors for L_(5)S_(1)lateral LDH.[Conclusion]The L_(5)S_(1)lateral LDH is associated with L_(5)S_(1)(∣∠α-∠β∣)and the abso⁃lute difference between L_(4/5)and L_(5)S_(1)∠C.

关 键 词：L5S1 旁侧型椎间盘突出 腰椎关节突关节 不对称 

分 类 号：R681.53[医药卫生—骨科学]