腰椎椎弓峡部裂患者的椎间盘退变及其相关因素  

Disc degeneration in patients with spondylolysis and its related factors

作　　者：戴力扬[1] 沈建中[1] 周之德[1] 姜其为[1] 

机构地区：[1]上海第二医科大学附属新华医院骨科,上海200092

出　　处：《临床骨科杂志》2002年第4期248-250,共3页Journal of Clinical Orthopaedics

摘　　要：目的　探讨腰椎椎弓峡部裂患者的椎间盘退变程度及其相关因素。方法　对 73例腰椎椎弓峡部裂行腰椎MRI检查 ,在正中矢状面MR图像上根据T2 加权像椎间盘信号强度判定相邻腰椎椎间盘退行性变程度 ,并与年龄、性别相同的正常人及无峡部裂的腰背痛患者进行比较 ,重点观察椎间盘退变程度与患者年龄、病程、临床症状严重程度及滑脱程度之间的关系。结果　峡部裂下方的椎间盘退变程度与患者年龄相关 (P <0 0 1) ,并较对照组严重 (P <0 0 1) ,但峡部裂上方椎间盘退变程度与对照组差别无显著性 (P >0 0 5 )。峡部裂下方椎间盘退变程度与病程相关 (P <0 0 1) ,但与患者症状严重程度及腰椎滑脱程度无相关性 (P >0 0 5 )。结论　滑脱节段椎间盘退变程度对于融合术式的选择较患者年龄及滑脱程度更为重要 。Objective To investigate the degree of disc degeneration in patients with spondylolysis and its related factors. Methods The grade of intervertebral disc degeneration in 73 symptomatic patients with lumbar spondylolysis was evaluated with magnetic resonance imaging to assess the degrees of disc degeneration. The results were compared with those of the age and sex matched asymptomatic control and with patients with clinical back pain but without spondylolysis. The relationship between disc degeneration and the age of patients, the duration and severity of clinical symptoms, and the grade of vertebral slip was evaluated respectively. A five point grading scale based on T 2 signal intensity recommended by Gibson et al. was used to evaluate the degree of disc degeneration. Results The grade of disc degeneration below the spondylolytic defect in the patients was highly significantly related to the age of patients ( P< 0 01) and was more severe than that in the controls ( P <0 01), but there was no difference of disc degeneration above the defect between the patients and the controls ( P >0 05). Furthermore, the grade of disc degeneration below the spondylolytic defect in the patients was highly significantly correlated with the duration of clinical symptoms( P <0 01), although it was not associated with severity of clinical symptoms or the grade of vertebral slip( P >0 05). Conclusion The degree of disc degeneration at the spondylolytic level is a more important determinant for the choice of the fusion procedure than the age of the patients or the grade of vertebral slip. Preoperative magnetic resonance examination is of great importance in evaluation of disc degeneration.

关 键 词：腰椎 脊椎前移 椎间盘 磁共振成像 

分 类 号：R681.5[医药卫生—骨科学]