年龄相关性的L4椎板腰部与下关节突尖端距离比值变化的研究
Age-related changes in the configuration of the L4 lamina and facet joints of lumbar spine
目的 研究腰椎椎板、小关节形态随着年龄变化的规律。 方法 选取300例无腰椎疾患的正常人为研究对象，行腰椎正侧位X线检查。将研究对象根据年龄分为6个组：（组 I:＜30岁, 组 II: 31~40岁, 组 III:41~50 岁, 组 IV: 51~60 岁, 组 V: 61~70岁, 组 VI:＞70岁）。测量L4椎板腰部（a）与腰4下关节突尖端之间的距离（b）的比值。 结果 a/b的比值在6个年龄组分别为0.825±0.101、0.836±0.088、0.840±0.098、0.858±0.084、0.878±0.091、0.890±0.119。伴随着年龄的增长其呈现逐渐增大的趋势。大于70岁组比值最大，与组I到组IV存在统计学差异。 结论 伴随着年龄的增长，椎板腰部的距离与下关节突尖端之间的距离比值逐渐增大，这意味着椎管横径逐渐狭窄、小关节更偏向于矢状位，发生退行性滑脱的可能性较大。
Objective To explore the age-related morphologic changes of lumbar laminas and facet joints morphology. Methods Three hundred spinal disease-free people coming for physical examination in our hospital underwent lumbar X-Ray examination were included in our study. All subjects were divided into 6 groups based on age (group I: 30 years of age, group II: 31~40 years, group III: 41~50 years, group IV: 51~60 years, group V: 61~70 years, and group VI: 70 years of age). We measured the distance of laminas waist (a) and inferior articular process (b) of lumbar 4. Then the Ratio of a/b was calculated. Results The value of a/b of group I to VI was 0.825±0.101, 0.836±0.088, 0.840±0.098, 0.858±0.084, 0.878±0.091 and 0.890±0.119 , respectively. The value of a/b in group VI was higher than other groups and statistical differences were found between group VI and other groups except group V. Conclusion The value of a/b gradually increases as people become older. This means value of transverse diameter of the vertebral canal becomes small and the orientation of the L4~L5 facet joints becomes more vertical with age.
/ Lumbar lamina / Lumbar facet joint / Lumbar spinal stenosis / Degeneration of lumbar spine
[1] Benoist M. Natural history of the aging spine[J]. Eur Spine J, 2003, 12(Suppl 2): 86-89.
[2] 张继业，朱青安，姜欢畅，等. 腰椎小关节不对称与小关节退变程度的关系及其临床意义[J]. 中国临床解剖学杂志, 2010，28(6): 629-633.
[3] Boos N，Weissbach S，Rohrbach H，et al, Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo Award in basic science[J]. Spine (Phila Pa 1976), 2002, 27(23): 2631-2644.
[4] Taylor JR, Twomey LT. Age changes in lumbar zygapophyseal joints. Observations on structure and function[J]. Spine (Phila Pa 1976), 1986, 11(7): 739-745.
[5] Sato K，Wakamatsu E，Yoshizumi A，et al. The configuration of the laminas and facet joints in degenerative spondylolisthesis. A clinicoradiologic study[J]. Spine, 1989, 14(11): 1265-1271.
[6] 钱宇，徐国健，金聪，等. 腰椎管狭窄症致压因素与减压方式关系的研究[J]. 中华骨科杂志, 2016，36(22): 1417-1425.
[7] 陈清汉，张树桧. 腰椎管狭窄症的病理生理学研究进展[J]. 中国矫形外科杂志, 2001，8(1): 59-61.
[8] Karacan I，Aydin T，Sahin Z，et al. Facet angles in lumbar disc herniation: their relation to anthropometric features[J]. Spine (Phila Pa 1976), 2004, 29(10): 1132-1136.
[9] Kalichman L，Suri P，Guermazi A，et al. Facet orientation and tropism: associations with facet joint osteoarthritis and degeneratives[J]. Spine (Phila Pa 1976), 2009, 34(16): E579-585.
[10]Fujiwara A，Tamai K，An H S，et al. Orientation and osteoarthritis of the lumbar facet joint[J]. Clin Orthop Relat Res, 2001, 4(385): 88-94.
[11]Williams R，Cheung JP，Goss B，et al. An international multicenter study assessing the role of ethnicity on variation of lumbar facet joint orientation and the occurrence of degenerative spondylolisthesis in Asia pacific: A study from the AOSpine Asia Pacific Research Collaboration Consortium[J]. Global Spine J, 2016, 6(1): 35-45.
[12]Boden SD，Riew KD，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.
[13]Samartzis D，Cheung JP，Rajasekaran S，et al. Critical values of facet joint angulation and tropism in the development of lumbar degenerative spondylolisthesis: An international, large-scale multicenter study by the AOSpine Asia Pacific Research Collaboration Consortium[J]. Global Spine J, 2016, 6(5): 414-421.
国家自然科学基金-青年科学基金项目（81601944）；广东省自然科学基金项目（2015A030310481）；广东省省级科技计划项目（2016A020215100）
京ICP备08002354号-3/
| 〈 |
|
〉 |
