仰臥位腰椎MRI小關(guān)節(jié)積液與退變性腰椎滑脫穩(wěn)定性關(guān)系的研究
發(fā)布時(shí)間：2018-08-25 12:35
【摘要】：目的：分析退變性腰椎滑脫患者仰臥位MRI中L4-5腰椎小關(guān)節(jié)積液與側(cè)臥過(guò)屈過(guò)伸側(cè)位X線上腰椎不穩(wěn)之間的相關(guān)性。 方法：選取自2013年2月-2015年2月在吉林大學(xué)中日聯(lián)誼醫(yī)院骨科行仰臥位腰椎MRI和側(cè)臥位過(guò)屈過(guò)伸位X線檢查的67例L4-5腰椎退變性疾病患者，其中有L4-5退變性腰椎滑脫同時(shí)仰臥位腰椎MRI中顯示關(guān)節(jié)積液量大于1mm患者為有積液組,有L4-5退變性腰椎滑脫仰臥位腰椎MRI中沒(méi)有顯示關(guān)節(jié)積液或關(guān)節(jié)積液量小于1mm的患者作為對(duì)照組。所有患者在仰臥位腰椎MRI T2加權(quán)序列上測(cè)量腰椎小關(guān)節(jié)積液和側(cè)臥位過(guò)屈過(guò)伸位X線片上評(píng)估腰椎不穩(wěn)。記錄L4-5腰椎小關(guān)節(jié)積液量的大小和腰椎不穩(wěn)滑移參數(shù)。以側(cè)臥位過(guò)屈過(guò)伸位X線片為標(biāo)準(zhǔn)。將有積液組與對(duì)照組的年齡、性別、腰椎移動(dòng)度、間盤(pán)退變分級(jí)、小關(guān)節(jié)炎分級(jí)、軟骨退變分級(jí)、小關(guān)節(jié)軟骨下骨化分級(jí)作比較，同時(shí)將有積液組內(nèi)積液量與移位度進(jìn)行相關(guān)性分析。 結(jié)果：67例病人中，32例在側(cè)臥位過(guò)屈過(guò)伸位X線片出現(xiàn)L4-5腰椎不穩(wěn)，35例在站立位過(guò)屈過(guò)伸側(cè)位X線上沒(méi)有出現(xiàn)不穩(wěn)。15例（22.39%）腰椎滑脫患者中可觀察到腰椎小關(guān)節(jié)積液，平均滑移度是5.027±1.134mm，平均小關(guān)節(jié)積液數(shù)值是3.09mm。52例（77.61%）腰椎滑脫患者中沒(méi)有觀察到腰椎小關(guān)節(jié)積液或關(guān)節(jié)積液量小于1mm。有積液組與對(duì)照組之間的年齡比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P0.05），，有積液組與對(duì)照組之間腰椎移動(dòng)度、腰椎角度變化、腰椎間盤(pán)退變分級(jí)、小關(guān)節(jié)炎分級(jí)、軟骨退變分級(jí)、小關(guān)節(jié)軟骨下骨化分級(jí)差異有統(tǒng)計(jì)學(xué)意義（P0.05），有積液組積液量與腰椎移動(dòng)度有相關(guān)性（r=0.919，P0.05）。 結(jié)論：無(wú)積液組腰椎穩(wěn)定性較有積液組腰椎穩(wěn)定性更穩(wěn)定，退變性腰椎滑脫腰椎小關(guān)節(jié)積液量與腰椎移動(dòng)度正相關(guān)。
[Abstract]:Objective: to analyze the correlation between L4-5 lumbar facet joint effusion and lateral overflexion extension X-ray instability in supine position MRI of degenerative lumbar spondylolisthesis. Methods: from February 2013 to February 2015, 67 patients with lumbar degenerative disease of L4-5 were examined by MRI in supine position and flexion and extension position in lateral position in Department of Orthopaedics, Sino-Japanese Friendship Hospital, Jilin University, from February 2013 to February 2015. Among them, L4-5 degenerative lumbar spondylolisthesis and supine lumbar MRI showed that the amount of joint effusion was larger in patients with 1mm than that in patients with 1mm. Patients with L4-5 degenerative lumbar spondylolisthesis in supine position had no joint effusion or joint effusion less than 1mm in supine position as control group. Lumbar instability was evaluated on MRI T2 weighted sequence in supine lumbar spine and lateral overflexion and extension position. L4-5 lumbar facet joint fluid volume and lumbar instability slip parameters were recorded. X-ray film of lateral position was taken as standard. Age, sex, lumbar mobility, disc degeneration, small arthritis, cartilage degeneration, subchondral ossification were compared between the hydrops group and the control group. At the same time, the correlation between the amount of fluid accumulated and the degree of displacement in the group with hydrops was analyzed. Results L4-5 lumbar vertebrae instability was found in 32 of 67 cases (22.39%) of lumbar spondylolisthesis in lateral supine position, and no instability of lumbar vertebrae was found in 35 cases of L4-5 unstable lumbar spine in standing position. 15 cases (22.39%) of lumbar spondylolisthesis were found to have effusion of lumbar facet joint. The average slip degree was 5.027 鹵1.134mm, and the mean value of fluid accumulation of facet joint was 77.61% (77.61%) of lumbar spondylolisthesis. No effusion or fluid was found in lumbar facet joint less than 1 mm. in the patients with lumbar spondylolisthesis, the mean slip degree was 5.027 鹵1.134mm. There was no significant difference in age between the hydrops group and the control group (P0.05). There was no significant difference in lumbar mobility, lumbar angle, lumbar disc degeneration, small arthritis, cartilage degeneration between the hydrops group and the control group. There was significant difference in subchondral ossification grade of facet joint (P0.05), and there was a correlation between fluid accumulation and lumbar mobility in the group with effusion (r = 0.919 P 0.05). Conclusion: the stability of lumbar vertebrae in the group without fluid is more stable than that in the group with fluid. The amount of fluid in the lumbar facet joint of degenerative lumbar spondylolisthesis is positively correlated with the degree of lumbar mobility.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3
本文編號(hào)：2202901
[Abstract]:Objective: to analyze the correlation between L4-5 lumbar facet joint effusion and lateral overflexion extension X-ray instability in supine position MRI of degenerative lumbar spondylolisthesis. Methods: from February 2013 to February 2015, 67 patients with lumbar degenerative disease of L4-5 were examined by MRI in supine position and flexion and extension position in lateral position in Department of Orthopaedics, Sino-Japanese Friendship Hospital, Jilin University, from February 2013 to February 2015. Among them, L4-5 degenerative lumbar spondylolisthesis and supine lumbar MRI showed that the amount of joint effusion was larger in patients with 1mm than that in patients with 1mm. Patients with L4-5 degenerative lumbar spondylolisthesis in supine position had no joint effusion or joint effusion less than 1mm in supine position as control group. Lumbar instability was evaluated on MRI T2 weighted sequence in supine lumbar spine and lateral overflexion and extension position. L4-5 lumbar facet joint fluid volume and lumbar instability slip parameters were recorded. X-ray film of lateral position was taken as standard. Age, sex, lumbar mobility, disc degeneration, small arthritis, cartilage degeneration, subchondral ossification were compared between the hydrops group and the control group. At the same time, the correlation between the amount of fluid accumulated and the degree of displacement in the group with hydrops was analyzed. Results L4-5 lumbar vertebrae instability was found in 32 of 67 cases (22.39%) of lumbar spondylolisthesis in lateral supine position, and no instability of lumbar vertebrae was found in 35 cases of L4-5 unstable lumbar spine in standing position. 15 cases (22.39%) of lumbar spondylolisthesis were found to have effusion of lumbar facet joint. The average slip degree was 5.027 鹵1.134mm, and the mean value of fluid accumulation of facet joint was 77.61% (77.61%) of lumbar spondylolisthesis. No effusion or fluid was found in lumbar facet joint less than 1 mm. in the patients with lumbar spondylolisthesis, the mean slip degree was 5.027 鹵1.134mm. There was no significant difference in age between the hydrops group and the control group (P0.05). There was no significant difference in lumbar mobility, lumbar angle, lumbar disc degeneration, small arthritis, cartilage degeneration between the hydrops group and the control group. There was significant difference in subchondral ossification grade of facet joint (P0.05), and there was a correlation between fluid accumulation and lumbar mobility in the group with effusion (r = 0.919 P 0.05). Conclusion: the stability of lumbar vertebrae in the group without fluid is more stable than that in the group with fluid. The amount of fluid in the lumbar facet joint of degenerative lumbar spondylolisthesis is positively correlated with the degree of lumbar mobility.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3
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