腰椎退行性变终板形态影像学表现及临床意义

目的 探讨下腰痛患者的软骨终板形态改变，并进一步研究软骨终板形态与腰椎间盘退变的关系。 方法 回顾性研究84例下腰痛患者。所有患者均行腰椎普通X线及MRI检查，依据MRI正中位像进行软骨终板形态分类及T2像对腰椎间盘退变分级，在侧位平片上进行椎间盘高度测量。 结果 退变腰椎软骨终板形态以扁平型多见。腰椎退行性变其椎间盘退变程度随凹形、扁平形到不规则形逐渐加重，且各型相比有显著性差异；退变椎间盘高度随凹形、扁平形到不规则形逐渐降低，但扁平形与不规则形相比统计学差异不明显。 结论 腰椎退行性变中扁平型软骨终板患者出现几率较高。凹形、扁平型和不规则形腰椎退行性变患者的腰椎间盘退变程度逐渐加重，扁平型和不规则形椎间隙高度降低明显,这对椎间盘髓核假体置换术具有一定指导意义。

Imageology and clinical significance of the degenerative lumbar endplates

 Objective　To examine the shape changes of the end plates in patients suffered from the lower back pain, and investigate the correlation between end plate and disc degeneration.  Methods 　Retrospective review was underwent in this study. The charts, operative reports, preoperative lateral plain radiographs, and MRI scans of 84 patients were reviewed and analyzed respectively. End plate shapes was determined on midsagittal MRI cuts, disc degeneration was graded on T2 sequences, and disc height was measured on lateral plain radiographs from L2 to S1 in all patients. Student t-test was used to detect significant differences and associations.   Results　For degenerative disc disease (DDD) patients, flat endplates were the most common shape in the lower lumbar spine. In addition, the concaved and irregular endplates could be found. The height of degenerated discs related with the shapes of endplate, viz, the highest of concaved endplate, and the lowest of irregular ones, and there was no difference between that of flat and irregular endplates.   Conclusions　The sagittal profile of end plates in the lumbar spine was described for patients with DDD. For those patients, most of severely degenerated disc present concave, flat or irregular endplates. the intervertebral space of flat and irregular discs are depressed obviously, which is helpful for direct the prosthetic disc nucleus-pulposus (PDN) replacement surgery.