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关节突关节不对称及方向与青年人脱垂型腰椎间盘突出症的相关性分析
作者:王德辉1  朱磊1 2  蒙格1  蒋赞利1 2  吴小涛1 2 
单位:1. 东南大学 医学院, 江苏 南京 210009;
2. 东南大学附属中大医院 脊柱外科, 江苏 南京 210009
关键词:关节突关节不对称 关节突关节方向 脱垂型腰椎间盘突出症 青年 
分类号:R682.1
出版年·卷·期(页码):2020·48·第九期(1107-1111)
摘要:

目的:研究关节突关节不对称(FT)与青年人脱垂型腰椎间盘突出症(PSLDH)及关节突关节方向与青年人髓核脱出方向的关系。方法:选择401例PSLDH患者(PSLDH组)及267例无腰椎间盘突出症(LDH)患者(对照组)作为研究对象。在CT上测量PSLDH组脱垂节段(L4/5或L5/S1)的双侧关节突关节角度(FJA)和对照组L4/5、L5/S1两个节段的双侧FJA。定义FT为双侧FJA差值>10°。同时观察髓核脱垂的方向与关节突关节的方向。结果:PSLDH组与对照组在L4/5、L5/S1节段出现FT的例数差异有统计学意义(P<0.05)。在PSLDH组脱垂的节段中,脱垂一侧关节突关节方向形态为冠状位方向的例数与矢状位方向的例数相比无显著性差异(P=0.860)。结论:FT与青年人PSLDH在L4/5及L5/S1节段均存在相关性;关节突关节方向与青年人髓核脱垂方向无相关性。

Objective: To investigate the association between facet tropism(FT) and prolapsed subtype of lumbar disc herniation(PSLDH) in young patients, and the relationship between facet joint orientation and the side of prolapsed nucleus pulposus. Methods: Four hundred and one patients with prolapsed subtype of lumbar disc herniation and 267 patients without lumbar disc herniation(LDH) were selected as study subjects. Facet joint angles(FJAs) of prolapsed segment (L4-L5 or L5-S1) in patients with PSLDH, both at L4-L5 and L5-S1 segments in controls were measured by CT. We defined FT as the difference between the angle of the right and left facet joint greater than 10°. Also, we observed the side of prolapsed nucleus pulposus and facet joint orientation.Results: The two groups had a significant statistic difference in the number of FT at L4-L5 and L5-S1 segments(P<0.05). However, there was no significant statistical difference between the coronally oriented facet joint and the sagittally oriented facet joint in the same side of prolapsed nucleus pulposus.Conclusion: Facet tropism is associated with extruded lumbar disc herniation at both L4-5 and L5-S1 levels in young patients. However, there is no relationship between facet joint orientation (more coronally or sagittally oriented) and the side of prolapsed nucleus pulposus.

参考文献:

[1] KALICHMAN L,HUNTER D J.Lumbar facet joint osteoarthritis:a review[J].Semin Arthritis Rheum,2007,37(2):69-80.
[2] DEGULMADI D,DAVE B,KRISHNAN A,et al.The relationship of facet joint orientation and tropism with lumbar disc herniation and degenerative spondylolisthesis in the lower lumbar spine[J].Asian Spine J,2019,13(1):22-28.
[3] NOREN R,TRAFIMOW J,ANDERSSON G B,et al.The role of facet joint tropism and facet angle in disc degeneration[J].Spine (Phila Pa 1976),1991,16(5):530-532.
[4] FARFAN H F,SULLIVAN J D.The relation of facet orientation to intervertebral disc failure[J].Can J Surg,1967,10(2):179-185.
[5] CYRON B M,HUTTON W C.Articular tropism and stability of the lumbar spine[J].Spine(Phila Pa 1976),1980,5(2):168-172.
[6] VERES S P,ROBERTSON P A,BROOM N D.The influence of torsion on disc herniation when combined with flexion[J].Eur Spine J,2010,19(9):1468-1478.
[7] MOHANTY S P,KANHANGAD M P,KAMATH S,et al.Zygapophyseal joint orientation and facet tropism and their association with lumbar disc prolapse[J].Asian Spine J,2018,12(5):902-909.
[8] DEGULMADI D,DAVE B R,KRISHNAN A.Age-and sex-related changes in facet orientation and tropism in lower lumbar spine:an MRI study of 600 patients[J].Eur Spine J,2019,28(5):961-966.
[9] WANG J,YANG X.Age-related changes in the orientation of lumbar facet joints[J].Spine(Phila Pa 1976),2009,34(17):E596-598.
[10] ALONSO F,KIRKPATRICK C M,JEONG W,et al.Lumbar facet tropism:a comprehensive review[J].World Neurosurg,2017,102:91-96.
[11] AHMED A M,DUNCAN N A,BURKE D L.The effect of facet geometry on the axial torque-rotation response of lumbar motion segments[J].Spine(Phila Pa 1976),1990,15(5):391-401.
[12] FARFAN H F,COSSETTE J W,ROBERTSON G H,et al.The effects of torsion on the lumbar intervertebral joints:the role of torsion in the production of disc degeneration[J].J Bone Joint Surg Am,1970,52(3):468-497.
[13] SCHMIDT H,KETTLER A,HEUER F,et al.Intradiscal pressure,shear strain,and fiber strain in the intervertebral disc under combined loading[J].Spine(Phila Pa 1976),2007,32(7):748-755.
[14] GHANDHARI H,AMERI E,HASANI H,et al.Is Facet Tropism Associated with Increased Risk of Disc Herniation in the Lumbar Spine?[J].Asian Spine J,2018,12(3):428-433.
[15] PICHAISAK W,CHOTIYARNWONG C,CHOTIYARNWONG P.Facet joint orientation and tropism in lumbar degenerative disc disease and spondylolisthesis[J].J Med Assoc Thai,2015,98(4):373-379.
[16] CHADHA M,SHARMA G,ARORA S S,et al.Association of facet tropism with lumbar disc herniation[J].Eur Spine J,2013,22(5):1045-1052.
[17] HELIOVAARA M.Body height,obesity,and risk of herniated lumbar intervertebral disc[J].Spine(Phila Pa 1976),1987,12(5):469-472.
[18] BOSTMAN O M.Body mass index and height in patients requiring surgery for lumbar intervertebral disc herniation[J].Spine (Phila Pa 1976),1993,18(7):851-854.
[19] VANHARANTA H,FLOYD T,OHNMEISS D D,et al.The relationship of facet tropism to degenerative disc disease[J].Spine(Phila Pa 1976),1993,18(8):1000-1005.
[20] CASSIDY J D,LOBACK D,YONG-HING K,et al.Lumbar facet joint asymmetry.Intervertebral disc herniation[J].Spine(Phila Pa 1976),1992,17(5):570-574.
[21] KUNAKORNSAWAT S,NGAMLAMAIDT K,TUNGSIRIPAT R,et al.The relationship of facet tropism to lumbar disc herniation[J].J Med Assoc Thai,2007,90(7):1337-1341.
[22] KO H Y,PARK B K.Facet tropism in lumbar motion segments and its significance in disc herniation[J].Arch Phys Med Rehabil,1997,78(11):1211-1214.
[23] BODEN S D,RIEWK D,YAMAGUCHI K,et al.Orientation of the lumbar facet joints:association with degenerative disc disease[J].J Bone Joint Surg Am,1996,78(3):403-411.
[24] ISHIHARA H,MATSUI H,OSADA R,et al.Facet joint asymmetry as a radiologic feature of lumbar intervertebral disc herniation in children and adolescents[J].Spine (Phila Pa 1976),1997,22(17):2001-2004.
[25] LEE D Y,AHN Y,LEE S H.The influence of facet tropism on herniation of the lumbar disc in adolescents and adults[J].J Bone Joint Surg Br,2006,88(4):520-523.
[26] WANG H,ZHOU Y.Facet tropism:possible role in the pathology of lumbar disc herniation in adolescents[J].J Neurosurg Pediatr,2016,18(1):111-115.
[27] ZHOU Q,TENG D,ZHANG T,et al.Association of facet tropism and orientation with lumbar disc herniation in young patients[J].Neurol Sci,2018,39(5):841-846.
[28] KONG M H,HE W,TSAI Y D,et al.Relationship of facet tropism with degeneration and stability of functional spinal unit[J].Yonsei Med J,2009,50(5):624-629.

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