腰痛椎间盘高度与Pfirrmann退变分级的关系△

Relationship between intervertebral disc height and Pfirrmann grade for degeneration in low back pain

摘要:

：［目的］探讨腰痛患者椎间盘高度与椎间盘退变程度的关系。［方法］回顾性分析 2021 年 1 月—2022 年 6 月于本院脊柱外科就诊的 151 例腰痛患者的腰椎 MRI 资料，测量椎间盘高度，采用 Pfirrmann 标准对椎间盘退变程度分级，使用 Spear- man 秩相关分析椎间隙高度与 Pfirrmann 的相关性。［结果］151 例患者影像椎间隙高度由低至高依次为 L_1~2、L₅~S₁、L_2~3、L_4~5、 L_3~4，差异有统计学意义 [(9.4±0.6)mm, (10.4±1.5)mm, (10.6±0.8)mm, (11.8±0.8)mm, (11.8±0.8)mm, P<0.05]；椎间隙 Pfirrmann 退变分级由轻至重依次为 L_1~2、L_2~3、L_3~4，L₅~S₁、L_4~5，差异有统计学意义（P<0.05）。L_1~2至 L₅~S₁的椎间隙高度均与其 Pfirrmann 退变程度分级呈显著负相关（r=-0.576, r=-0.578, r=-0.411, r=-0.409, r=-0.828, P<0.001）。［结论］椎间盘高度可作为腰椎间盘退行性变程度的简易评价指标，具有一定临床参考价值。

Abstract:

[Objective] To investigate the relationship between the intervertebral disc height and the Pfirrmann classification for inter- vertebral disc degeneration in low back pain. [Methods] A retrospective study was conducted on the lumbar MRI data of 151 patients who visited the Department of Spinal Surgery of our hospital for low back pain from January 2021 to June 2022. The intervertebral disc height was measured, and the degree of intervertebral disc degeneration were assessed by using Pfirrmann criteria. Spearman rank correlation was used to search the correlation between intervertebral space height and Pfirrmann grade. [Results] The intervertebral disc height of the 151 pa- tients was ranked down-up as L_1~2, L₅~S₁, L_2~3, L_4~5 and L_3~4, which was statistically significant [(9.4±0.6)mm, (10.4±1.5)mm, (10.6±0.8)mm, (11.8±0.8)mm, (11.8±0.8)mm, P＜0.05]. The Pfirrmann grade for intervertebral disc degeneration was ranked mild-severe as L_1~2, L_2~3, L_3~4, L₅~S₁, L_4~5, with statistically significant difference among the levels (P＜0.05). All the intervertebral disc heights from L_1~2 to L₅~S₁ were nega- tively correlated with the extents of degeneration in term of Pfirrmann grade significantly (r=-0.576, r=-0.578, r=-0.411, r=-0.409, r=- 0.828, P＜0.001). [Conclusion] The intervertebral disc height might be used as a simple parameter to evaluate the degree of lumbar interver- tebral disc degeneration, which has certain clinical reference value.