本文選題：脊椎滑脫 + 椎間盤退行性變��； 參考：《安徽醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的探討關(guān)節(jié)突關(guān)節(jié)角的改變與退變性腰椎滑脫(DLS)的發(fā)生之間的因果關(guān)系。方法回顧性選取2010年1月～2013年7月安徽醫(yī)科大學(xué)附屬省立醫(yī)院骨科收治的100例單純L4/5退變性滑脫患者作為DLS組,同期100例無(wú)腰腿痛和脊椎滑脫且性別、年齡與DLS組相匹配的正�；颊咦鳛閷�(duì)照組。2組均行站立位腰椎正側(cè)位片及腰椎CT檢查,在x線上測(cè)量腰椎滑脫Boxall指數(shù)；在CT圖像上選取平行于L3/4、L4/5、L5/S1椎間隙上緣終板的關(guān)節(jié)面CT橫斷圖像作為關(guān)節(jié)突關(guān)節(jié)的頭側(cè)部分；平行于L3/4、L4/5、L5/S1椎間隙下緣終板的關(guān)節(jié)面CT橫斷圖像作為關(guān)節(jié)突關(guān)節(jié)的尾側(cè)部分,并測(cè)量頭尾側(cè)關(guān)節(jié)突關(guān)節(jié)與椎體冠狀面的夾角,并在CT骨窗下對(duì)頭尾側(cè)關(guān)節(jié)突關(guān)節(jié)的退變程度進(jìn)行分級(jí)。結(jié)果DLS組L4/5頭側(cè)關(guān)節(jié)突關(guān)節(jié)角58.8±6.3°大于對(duì)照組的50.6±7.9°,尾側(cè)關(guān)節(jié)突關(guān)節(jié)角56.2±6.1。大于對(duì)照組的47.1±7.8。,差異均具有顯著性(P0.01)。DLS組患者L4/5頭尾側(cè)角度差值2.4±0.6°小于對(duì)照組的4.9±1.7。,差異有顯著性(P0.01)。DLS組L4/5左右兩側(cè)關(guān)節(jié)突關(guān)節(jié)角不對(duì)稱度7.8±2.0°大于對(duì)照組的5.1±1.6。,差異有顯著性(P0.01)。按關(guān)節(jié)突關(guān)節(jié)退變等級(jí)將DLS患者分成3組,各組間滑脫Boxall指數(shù)差異有顯著性(P0.05),而不同退變等級(jí)中頭、尾側(cè)關(guān)節(jié)突關(guān)節(jié)角度差異無(wú)顯著性(P0.05)；結(jié)論關(guān)節(jié)突關(guān)節(jié)空間方向上的改變是退變性腰椎滑脫過(guò)程中應(yīng)力作用下二次重塑的結(jié)果。
[Abstract]:Objective to investigate the causal relationship between the change of articular facet joint angle and the occurrence of degenerative lumbar spondylolisthesis. Methods from January 2010 to July 2013, 100 cases of simple L 4 / 5 degenerative spondylolisthesis treated in the Department of Orthopaedics, affiliated Provincial Hospital of Anhui Medical University were selected as DLS group. In the same period, 100 cases were without low back pain and spondylolisthesis and sex. The normal patients with age matched with DLS group were treated as control group (group 2). All the patients were examined by standing lumbar vertebrae and lumbar CT, and the Boxall index of lumbar spondylolisthesis was measured on the X ray of Lumbar Spondylolisthesis. The CT transection of the articular surface parallel to the upper marginal endplate of the intervertebral space of L3 / 4 / 5 / 5 / S1 was selected as the head part of the articular facet joint on CT images, and the CT transection image of the articular surface parallel to the L4 / 4 / L4 / 5 / L5 / S1 end plate of the lower margin of the intervertebral space was used as the tail part of the articular facet joint. The angle between the head and tail facet joint and the coronal plane of the vertebral body was measured, and the degree of degeneration of the head and tail facet joint was graded under the CT bone window. Results in DLS group, 58.8 鹵6.3 擄of L4 / 5 head facet joint angle was higher than that of control group (50.6 鹵7.9 擄), and 56.2 鹵6.1 擄of caudal facet joint angle. There was significant difference in angle difference of L4 / 5 head and tail between the DLS group and the control group (2.4 鹵0.6 擄vs 4.9 鹵1.7.The difference was significant). There was a significant difference in the angle asymmetry between the L4 / 5 and DLS groups (7.8 鹵2.0 擄vs 5.1 鹵1.6.The difference was significant (P 0.01)). According to the grade of degenerative articular process, DLS patients were divided into three groups. The Boxall index of slippage was significantly different among the three groups (P 0.05), but the middle head of different grade of degeneration. Conclusion the spatial change of articular facet joint is the result of secondary remodeling under stress during degenerative lumbar spondylolisthesis.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R681.5

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