腰椎不稳与稳定腰痛患者的MRI参数比较

MRI parameter comparison in low back pain with or without lumbar instability

摘要:

[目的] 探讨腰椎不稳与稳定腰痛患者MRI 测量参数（magnetic resonance imaging parameters, MRIPs） 的差异。[方法] 回顾性分析本院2021 年1 月1 日—2023 年8 月31 日收治的361 例腰痛患者的临床资料，根据在过伸过屈动态腰椎X 线片腰椎体滑移是否＞3 mm 分为不稳组181 例，稳定组180 例。比较两组腰椎MRI 参数的差异，包括小关节积液厚度、关节突关节夹角（facet joint angle, FJA）、椎间盘高度指数（disc height index, DHI）。[结果]右侧不稳组关节积液厚度显著大于稳定组[(1.2±0.8) mmvs (0.9±0.7) mm, P=0.023]，不稳组两侧FJA 均显著大于稳定组[左侧: (61.2±9.8)° vs (57.2±8.4)°, P=0.039; 右侧: (62.9±10.1)° vs (59.1±6.5)°, P=0.003]，不稳组的DHI 显著小于稳定组[(0.3±0.1) % vs (0.3±0.1) %, P=0.005]。此外，不稳定组椎间盘退变分级显著重于稳定组（P＜0.05）。[结论] 对腰痛患者进行MRIPs 测量可对腰椎不稳做出准确评价并为手术方案制定提供依据。

Abstract:

[Objective] To investigate the difference of magnetic resonance imaging parameters (MRIPs) in low back pain with or with-out lumbar instability. [Methods] A retrospective analysis was performed on 361 patients who were diagnosed of low back pain in our hospi-tal from January 1, 2021 to August 31, 2023. Based on whether lumbar translation ＞3 mm on the dynamic lateral X-rays at hyperextensionand hyperflexion, 181 cases were fall into the unstable group, while the remaining 180 case were into the stable group. The MRI parametersof lumbar spine, including the thickness of the facet joint effusion, facet joint angle (FJA), and disc height index (DHI), were compared be-tween the two groups. [Results] The unstable group proved significantly greater than the stable group in terms of joint effusion thickness[(1.2±0.8) mm vs (0.9±0.7) mm, P 0.023], and FJA on both sides [left, (61.2±9.8)° vs (57.2±8.4)°, P 0.039; right, (62.9±10.1)° vs (59.1±6.5)°, P 0.003], while the former had significantly less DHI than the latter [(0.3±0.1) % vs (0.3±0.1) %, P 0.005]. In addition, the unstablegroup was marked significantly severer degeneration grade than the stable group (P＜0.05). [Conclusion] MRIPs measurement in low backpain might accurately evaluate lumbar instability and provide a basis for surgical planning.