L_1椎体压缩骨折与邻近椎小关节结构变化的相关性CT研究

目的:通过测量L1压缩椎体邻近椎小关节的角度、间隙,观察L1椎体压缩后邻近椎小关节的变化。探讨L1压缩椎体前后缘的比值与邻近椎小关节角度、间隙的关系。方法:应用64层螺旋CT对120例L1压缩椎体(压缩组)与有腰部疼痛但无L1椎体压缩的120例(对照组),进行邻近椎小关节结构及形态特点的对比分析。测量邻近椎小关节冠状位、矢状位、横断位的角度、间隙,将2组数据进行组间t检验分析。结果:以L1为中心,分为上下关节,以中轴线为中心,分为右、左关节。2组椎小关节的数据行统计学分析:冠状位角度差异无统计学意义(P值>0.05),矢状位、横断位角度差异均有统计学意义(P值<0.05);冠、矢、横断位椎小关节间隙的差异均无统计学意义(P值>0.05)。结论:L1椎体压缩骨折对邻近椎小关节间隙基本无影响;角度:冠状位基本无影响,横断位轻度变小,矢状位明显变小,但与椎体压缩程度不成比例。当矢状位上下椎弓根角(以L1为中心):上方<71.4°或下方<80.2°时,对胸腰段的生理曲度及脊柱的稳定性影响明显。

CT Investigation on the relationship between the compressed fracture of the first lumbar vertebrae and zygapophyseal joint around the first lumbar vertebrae

Objective：The aim was to analyze the relationship between the compressed fracture of the first lumbar vertebrae and zygapophyseal joint around the first lumbar vertebrae through measuring the zygapophyseal joint data around the first compressed fracture of lumbar vertebrae.Methods：Two hundred and forty patients of the first lumbar vertebrae were examined with 64-slice CT.In 120 of 240 patients had the compressed fracture of the first lumbar vertebrae while the other 120 cases had not.All of the first lumbar vertebrae’s angle and space were measured and the data were analyzed on the coronal section,sagittal section,transverse section.Results：The up and down joint was centred on the first lumbar vertebrae.The right and left joint was centred on the first lumbar vertebrae.There were significant differences on the zygapophyseal joint angle on sagittal section between the two groups（P〈0.05）;there were no significant differences of the zygapophyseal joint of angle on coronal section（P〉0.05）.There were differences of the zygapophyseal joint angle on transverse section（P〈0.05）.There were no significant differences of the zygapophyseal joint of space among sagittal section,coronal section and transverse section（P〉0.05）.Conclusion：There was no influence on the zygapophyseal joint space.The angle of zygapophyseal joint around the first compressed fracture of lumbar vertebrae：There was no influence on coronal section.There were differences on transverse section（P〈0.05）.The zygapophyseal joint angle got much smaller on sagittal section,but the zygapophyseal joint angle on sagittal section was out of proportion with the compressed fracture of the first lumbar.There is significant influence on lumbar vertebrae when the sagittal section angel was less than 71.4 degree of up Zygapophyseal joint angel or 80.2 degree of down Zygapophyseal joint angel.