Effect of Disc Degeneration on Lumbar Segmental Mobility Analyzed by Kinetic Magnetic Resonance Imaging
Effect of Disc Degeneration on Lumbar Segmental Mobility Analyzed by Kinetic Magnetic Resonance Imaging
复制标题
动态磁共振成像分析椎间盘退变对腰椎节段活动度的影响
DOI：
10.1097/brs.0000000000000738
复制
发表时间：
2015-03-01
期刊：
影响因子：
3
通讯作者：
Wang, Jeffrey C.
中科院分区：
文献类型：
--
作者：
Lao, Lifeng;Daubs, Michael D.;Wang, Jeffrey C.
研究设计。摘要目的：回顾放射学研究。目的：通过动态磁共振成像，明确腰椎退变程度与腰椎运动的关系。椎间盘退变在中年后很常见。腰椎不稳被普遍认为是下腰痛的潜在危险因素。然而，腰椎间盘退变程度与腰椎活动度之间的相关性还有待进一步研究。对162例无手术史的症状性下腰痛患者进行了动态磁共振成像。脊柱外科医生根据退变分级系统(I-V级)对腰椎间盘进行分级。测量L1-L2至L5-S1各节段的平移运动和角度变化。分析腰椎间盘退变程度与腰椎活动度的关系。I~IV级椎间盘的平移活动度逐渐增加，但随V级的增加而减小。与其他退变程度较轻的椎间盘相比，V级椎间盘的总平移活动度显著降低(P<；0.05)。与其他退变程度(I~IV级)相比，V级腰椎间平移活动度显著降低(P<；0.05)。对于退变程度较小的I级和II级椎间盘，L2-L3和L3-L4节段单位贡献了脊柱总角活动度的大部分。但对于退变严重的V型节段，L2-L3和L3-L4的贡献显著降低(P<；0.01)。随着腰椎间盘退变从正常发展到日益严重的阶段，腰椎的运动从正常阶段发展到活动度较高的不稳定阶段，最后发展到稳定性增加的强直期。
Study Design. Retrospective radiographical study.Objective. To define the relationship between the grade of disc degeneration and the motion of the lumbar spine by using kinetic magnetic resonance imaging.Summary of Background Data. Disc degeneration is common after middle age. Lumbar instability has generally been recognized as a potential risk factor of low back pain. However, correlations between the grade of disc degeneration and the motion of the lumbar spine need more investigation.Methods. Kinetic magnetic resonance imaging was performed in 162 patients with symptomatic low back pain without prior history of surgery. The lumbar intervertebral discs were graded by spine surgeons according to the degenerative grading system (grades I-V). Translational motion and angular variation were measured at each segment from L1-L2 through L5-S1. The relationship between the degree of lumbar disc degeneration and extent of lumbar spine mobility was analyzed.Results. The translational motion in discs with grade I through IV increased gradually, but decreased with grade V. Compared with other less degenerative grades, grade V discs had significantly decreased total intervertebral translational motion (P < 0.05). The angular variation in discs with grade I through IV was fairly constant, but decreased with grade V. Compared with other degenerative grades (I-IV), grade V discs had significantly decreased total intervertebral translational motion (P < 0.05). For less degenerative grades I and II discs, the L2-L3 and L3-L4 segmental units contributed the majority of total angular mobility of the spine. However, for the severely degenerated segments, grade V discs, the contributions of the L2-L3 and L3-L4 significantly decreased (P < 0.01).Conclusion. As disc degeneration developed from the normal to an increasingly severe stage, the motion of lumbar spine progressed from the normal stage to an unstable phase with higher mobility and finally to an ankylosed stage where stability was increased.