【摘要】 目的通过研究邻近节段腰椎小关节方向探讨关节突关节倾斜度与退行性腰椎滑脱（lumbar degenerative spondylolisthesis,LDS）之间的因果关系。方法将2013年至2015年南方医院住院的120例L4⁵退行性腰椎滑脱患者纳入LDS组,再选取120例L4⁵峡部裂性腰椎滑脱患者纳入峡部裂腰椎滑脱（lumbar isthemic spondylolisthesisat,LIS）组,对照组（lumbar spondylolisthesis-free,LS-free组）由在南方医院进行体检的120例无脊柱疾病的人组成。基于CT图像分析腰椎关节突关节的方向。在L_2³、L_3⁴、L_4⁵和L₅S₁的节段,测量水平面腰椎关节突关节角度,并记录年龄、身高、性别、体重等基本信息。结果峡部裂性腰椎滑脱（LIS组）各节段关节突关节角与对照组（LS-free组）差异无统计学意义（P>0.05）,退行性腰椎滑脱（LDS组）各节段关节突关节角与对照组（LS-free组）差异有统计学意义（P<0.01）。不同程度退行性腰椎滑脱的非滑脱节段关节突关节角度之间差异无统计学意义（P>0.05）。L_3⁴与L_4⁵关节突关节角度线性相关（R=0.575）。结论滑脱对邻近节段关节突关节角度无影响,邻近节段关节突关节角度呈线性相关。退行性腰椎滑脱关节突关节角度均小于正常人,且该小于正常人群的关节突关节角度在滑脱前已经存在,为滑脱危险因素。滑脱节段关节突关节存在滑脱后形变。更多还原

【Abstract】 Objective To explore the cause-effect relationship between facet joint orientations and lumbar degenerative spondylolisthesis.Methods 120 patients with Lumbar Degenerative Spondylolisthesis at L_4⁵ who were hospitalized in Nanfang Hospital from 2013 to 2015were included in this study.120 patients with Isthemic Spondylolisthesis at L_4⁵ who were hospitalized in Nanfang Hospital from 2013 to 2015were included in this study.The control group was consisted of 120 spinal disease-free people who came for annual physical examination in Nanfang hospital.The orientations of the lumbar facet joints were analyzed based on CT tomography images.At the segments of L_2³,L_3⁴,L_4⁵ and L₅S₁,facet joint angulations were measured and the correlation of angulation at L_3⁴,L_4⁵ were analyzed.ResultsThere was no significant difference between Lumbar Isthemic Spondylolisthesis（LIS group）and the control group（LS-free group）in facet joints（P>0.05）.There was significant difference between lumbardegenerative spondylolisthesis（LDS group）and the control group（LS-free group）in facet joints（P<0.01）.There was no significant difference between different degree degenerative lumbar spondylolisthesis in facet joint angle at L_2³,L_3⁴ and L₅S₁.L_3⁴ and L_4⁵（P>0.05）.There was a linear correlation between L_3⁴ and L_4⁵ facet joint angle（R=0.575）.Conclusion Spondylolisthesis had no effect on the facet joint angle at adjacent segment,and the angle of facet joint at different segments was linearly correlated.The angle of facet joint at different segments in LDS groupwere less than LS-free group,and the joint structure other than bony elements seemed to be the early pathological change of facet joints.The bony structure change of facet joints that based on bone remolding adapted to mechanical burden was secondary to ongoing slippage.更多还原