腰椎关节突关节方向与年龄相关变化及其与退行性椎体滑脱的关系分析  

Analysis of Age-Related Changes in the Direction of Lumbar Facet Joints and Their Relationship with Degenerative Spondylolisthesis

作　　者：孙慧 刘彩云 庄重 孙晓忠 黄健雷 赵少聪 SUN Hui;LIU Caiyun;ZHUANG Zhong(Department of Radiology,People’s Hospital of Tongshan District,Xuzhou City,Jiangsu Province 221000;不详)

机构地区：[1]江苏省徐州市铜山区人民医院影像科,221000 [2]无锡市惠山区中医医院影像科

出　　处：《医学理论与实践》2025年第6期927-930,944,共5页The Journal of Medical Theory and Practice

基　　金：江苏省卫生健康委课题(Z2023035);无锡市中医药课题(ZYYB09)。

摘　　要：目的:探讨正常健康人群轴位、矢状位腰椎关节突关节面方向与年龄相关的变化情况,腰椎关节突关节面方向变化与单个退行性腰椎滑脱的关系。方法:收集我院2023年4月—2024年3月行全腹部CT检查者461例,其中406例正常健康人作为对照组,根据不同年龄段(≤50岁、51~60岁、61~70岁、≥71岁)评估关节突关节面方向及关节突关节不对称性(FJT),单节段退行性腰椎滑脱患者55例作为单节段退行性腰椎滑脱组,比较单节段退行性腰椎滑脱组与对照组关节突关节面方向和FJT的变化情况。在CT图像上定量测量轴位、矢状位L_(1~5)关节突关节角度(FJA)。结果:女性矢状位L_(2/3)(P=0.005)、L_(3/4)(P=0.013)、L_(4/5)(P=0.007)及轴位L_(4/5)(P=0.010)、L_(5)/S_(1)(P=0.015)FJA随年龄增加而减小,关节突关节面方向逐渐趋向于水平化和矢状化;男性矢状位L_(3/4)(P=0.001)、L_(4/5)(P=0.001)FJA亦随年龄增长而减小,关节突关节面方向逐渐趋向于水平化;女性L_(4/5) FJA随年龄变化最明显。与对照组相比:单节段退行性腰椎滑脱组在轴位上更加矢状化,在矢状位上更加水平化,单节段腰椎滑脱段及邻近节段轴位、矢状位FJT发生率均更高。结论:下腰椎关节突关节方向随年龄增长而逐渐趋向于水平化、矢状化,以L_(4/5)为著。腰椎关节突关节方向矢状化和水平化趋势及多节段FJT可能是单节段退行性椎体滑脱的危险因素。Objective:Explore age-related changes of orientation of facet joint in both the axial and sagittal planes on computed tomography among healthy people and compare these changes with those in the single-level degenerative spondylolisthesis.Methods:A total of 461 people for whom full abdominal computed tomography scans were obtained at our hospital between April 2023 to March 2024 were included.Their were divided into a control group(406 healthy people)and single-level degenerative spondylolisthesis group(55 patients).Facet joint orientation and joint facet tropism were evaluated in the control group according to patient age(≤50 years,51~60 years,61~70 years,≥71 years).The findings in the control group were compared with those in the single-level degenerative spondylolisthesis goup.Facet joint angle at each level was measured in the axial and sagittal planes on computed tomography images.Results:Facet joint angle decreased with age at L_(2/3)(P=0.005)and L_(3/4)(P=0.013)and L_(4/5)(P=0.007)in women and L_(3/4)(P=0.001)and L_(4/5)(P=0.001)in men in the sagittal plane and L_(4/5)(P=0.010)and L_(5)/S_(1)(P=0.015)in women in the axial plane.The variation in the facet joint angle was greatest at L_(4/5) in women.Compared with the control group,patients with single-level degenerative spondylolisthesis showed more sagittally and horizontally oriented facet joints in the axial and sagittal planes and a significantly higher prevalence of multilevel facet tropism and tropism at levels adjacent.Conclusion:The axial and sagittal orientation of facet joints in the lower lumbar vertebra,especially L_(4/5),was negatively correlated with age.The orientation of the lumbar facet joints and multilevel joint facet tropism are correlated with single-level degenerative spondylolisthesis.

关 键 词：退行性椎体滑脱 腰椎关节突关节方向 腰椎关节突关节不对称性 

分 类 号：R684.7[医药卫生—骨科学]