The relationship between disc degeneration, facet joint osteoarthritis, and stability of the degenerative lumbar spine
The relationship between disc degeneration, facet joint osteoarthritis, and stability of the degenerative lumbar spine
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DOI：
10.1097/00002517-200010000-00013
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发表时间：
2000-10-01
期刊：
影响因子：
--
通讯作者：
Saotome, K
中科院分区：
文献类型：
--
作者：
Fujiwara, A;Tamai, K;Saotome, K
椎间盘和小关节的退化过程会影响运动节段的稳定性。文献中尚未明确椎间盘退变、小关节骨关节炎和运动节段的运动学之间的确切关系。对腰椎的磁共振成像和功能性放射线检查进行分析，以检查节段不稳定性之间的关系。小关节骨关节炎和腰椎退行性疾病患者的椎间盘退变。连续 70 名患者（平均年龄 46 岁）接受了磁共振成像以及腰椎屈曲和伸展 X 光检查。腰椎不稳定分为屈曲异常倾斜、矢状面旋转不稳定和平移不稳定。平移不稳定性又分为前部不稳定性。后部和前后部平移不稳定。在 T2 加权矢状图像上看到的椎间盘退变分为五个等级。在轴向 T1 加权图像上看到的小关节骨关节炎分为四个等级。这项研究表明，腰椎运动节段的运动学受到椎间盘退变和小关节骨关节炎的影响。屈曲时异常倾斜运动和前后平移不稳定性均与小关节骨关节炎呈负相关。然而。前部平移不稳定与椎间盘退变和小关节骨关节炎呈正相关。矢状面的旋转不稳定和后平移不稳定与椎间盘退变和小关节骨关节炎无关。
Degenerative processes in the disc and facet joints affect the stability of the motion segment. The exact relations among disc degeneration, facet joint osteoarthritis, and the kinematics of the motion segment are not well defined in the literature. Magnetic resonance imaging and functional radiography of the lumbar spine were analyzed to examine the relations among segmental instability. facet joint osteoarthritis, and disc degeneration in patients with degenerative disorders of the lumbar spine. Seventy consecutive patients (mean age, 46 years) had both magnetic resonance imaging and flexion and extension radiographs of the lumbar spine. The lumbar instability was classified into abnormal tilting on flexion, rotatory instability in the sagittal plane, and translatory instability. Translatory instability was subdivided into anterior. posterior, and anteroposterior translatory instability. Disc degeneration as seen on T2-weighted sagittal images was classified into five grades. Facet joint osteoarthritis as seen on axial T1-weighted images was divided into four grades. This study revealed that the kinematics of the lumbar motion segment an affected by disc degeneration and facet joint osteoarthritis. Abnormal tilting movement on flexion and anteroposterior translatory instability both had negative associations with facet joint osteoarthritis. However. anterior translatory instability was positively associated with disc degeneration and facet joint osteoarthritis. Rotatory instability in the sagittal plane and posterior translatory instability were not associated with disc degeneration and facet joint osteoarthritis.