84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]鄢來軍,葛海雅,周斌,等.峽部裂性與退變性腰椎滑脫患者腰椎退變程度的影像學(xué)比較研究[J].中醫(yī)正骨,2023,35(02):15-21.
　YAN Laijun,GE Haiya,ZHOU Bin,et al.A comparative imaging study of the degree of lumbar vertebrae degeneration of isthmic spondylolisthesis versus degenerative spondylolisthesis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(02):15-21.
點擊復(fù)制

峽部裂性與退變性腰椎滑脫患者腰椎退變程度的影像學(xué)比較研究()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年02期
頁碼:
15-21
欄目:
臨床研究
出版日期:
2023-02-20

文章信息/Info

Title:
A comparative imaging study of the degree of lumbar vertebrae degeneration of isthmic spondylolisthesis versus degenerative spondylolisthesis
作者:
鄢來軍1; 葛海雅2; 周斌1; 袁宏杰1; 詹紅生2
(1.南通市中醫(yī)院,江蘇 南通 226000; 2.上海中醫(yī)藥大學(xué)附屬曙光醫(yī)院,上海 201203)
Author(s):
YAN Laijun1; GE Haiya2; ZHOU Bin1; YUAN Hongjie1; ZHAN Hongsheng2
1.Nantong Hospital of Traditional Chinese Medicine,Nantong 226000,Jiangsu,China 2.Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China
關(guān)鍵詞:
脊椎滑脫;  腰椎;  椎間盤退化;  放射攝影術(shù);  磁共振成像
Keywords:
spondylolysis;  lumbar vertebrae;  intervertebral disc degeneration;  radiography;  magnetic resonance imaging
摘要:
目的:比較峽部裂性與退變性腰椎滑脫患者的腰椎退變程度。方法:回顧性分析2015年1月至2022年3月在南通市中醫(yī)院收治的170例腰椎滑脫患者的病例資料,其中峽部裂性滑脫85例(峽部裂組)、退變性滑脫85例(退變組)。在腰椎側(cè)位X線片上采用Meyerding分級標(biāo)準(zhǔn)評估腰椎滑脫程度; 在腰椎MRI上采用Pfirrmann分級標(biāo)準(zhǔn)評估椎間盤退變程度,采用Modic改變分級標(biāo)準(zhǔn)評估終板退變程度,采用Weishaupt分級標(biāo)準(zhǔn)評估關(guān)節(jié)突關(guān)節(jié)退變程度。比較2組患者的腰椎滑脫Meyerding分級、椎間盤Pfirrmann分級、終板Modic改變分級及關(guān)節(jié)突關(guān)節(jié)Weishaupt分級。結(jié)果:①腰椎滑脫Meyerding分級。峽部裂組腰椎滑脫MeyerdingⅠ度32例、Ⅱ度48例、Ⅲ度5例,退變組腰椎滑脫MeyerdingⅠ度59例、Ⅱ度26例; 峽部裂組腰椎滑脫程度較退變組更嚴(yán)重(Z=-4.323,P=0.000)。②椎間盤Pfirrmann分級。峽部裂組椎間盤PfirrmannⅢ級43例、Ⅳ級34例、Ⅴ級8例,退變組椎間盤PfirrmannⅢ級33例、Ⅳ級47例、Ⅴ級5例; 2組患者椎間盤退變程度比較,差異無統(tǒng)計學(xué)意義(Z=-1.121,P=0.262)。③終板Modic改變分級。峽部裂組終板Modic0級18例、Ⅰ級7例、Ⅱ級46例、Ⅲ級14例,退變組終板Modic0級27例、Ⅰ級6例、Ⅱ級47例、Ⅲ級5例; 峽部裂組終板退變程度較退變組更嚴(yán)重(Z=-2.051,P=0.040)。④關(guān)節(jié)突關(guān)節(jié)Weishaupt分級。峽部裂組關(guān)節(jié)突關(guān)節(jié)Weishaupt0級2例、Ⅰ級27例、Ⅱ級33例、Ⅲ級23例,退變組關(guān)節(jié)突關(guān)節(jié)WeishauptⅠ級25例、Ⅱ級30例、Ⅲ級30例; 2組患者關(guān)節(jié)突關(guān)節(jié)退變程度比較,差異無統(tǒng)計學(xué)意義(Z=-1.140,P=0.254)。結(jié)論:峽部裂性腰椎滑脫患者與退變性腰椎滑脫患者的椎間盤與關(guān)節(jié)突關(guān)節(jié)退變程度相似,但前者的腰椎滑脫和終板退變程度較后者更嚴(yán)重。
Abstract:
Objective:To compare the degree of lumbar vertebrae degeneration between patients with isthmic spondylolisthesis(IS)and patients with degenerative spondylolisthesis(DS).Methods:The medical data of 170 patients with spondylolisthesis admitted to Nantong Hospital of Traditional Chinese Medicine from January 2015 to March 2022 were retrospectively analyzed,including 85 cases with IS(IS group)and 85 cases with DS(DS group).The degree of lumbar spondylolisthesis was evaluated by using Meyerding classification criteria on lateral radiographs of lumbar vertebrae.The Pfirrmann grading scale was used to assess the degree of intervertebral disc degeneration on lumbar magnetic resonance imaging(MRI)images.The Modic changes classification method was employed to evaluate the degree of vertebral endplate degeneration.The degree of facet joint degeneration was assessed using the Weishaupt scale.Meyerding grading of lumbar spondylolisthesis,Pfirrmann grading of intervertebral disc,Modic change grading of vertebral endplate,and Weishaupt grading of facet joint were compared between the two groups.Results:①M(fèi)eyerding grading of lumbar spondylolisthesis.In the IS group,there were 32 cases of Meyerding gradeⅠ,48 cases of gradeⅡ,and 5 cases of gradeⅢ; while in the DS group,there were 59 cases of Meyerding gradeⅠand 26 cases of gradeⅡ.The spondylolisthesis was more severe in the IS group than in the DS group(Z=-4.323,P=0.000).②Pfirrmann grading of intervertebral disc.In the IS group,there were 43 cases of Pfirrmann gradeⅢ,34 cases of gradeⅣ,and 8 cases of gradeⅤ; and there were 33 cases of Pfirrmann gradeⅢ,47 cases of gradeⅣ,and 5 cases of gradeⅤin the DS group.There was no significant difference in the degree of intervertebral disc degeneration between the two groups(Z=-1.121,P=0.262).③Modic change grading of vertebral endplate.In the IS group,there were 18 cases of Modic type-0,7 cases of type-Ⅰ,46 cases of type-Ⅱ,and 14 cases of type-Ⅲ; while in the DS group,there were 27 cases of Modic type-0,6 cases of type-Ⅰ,47 cases of type-Ⅱ,and 5 cases of type-Ⅲ.The degeneration of vertebral endplate in the IS group was more severe than that in the DS group(Z=-2.051,P=0.040).④Weishaupt grading of facet joint.There were 2 cases of Weishaupt grade 0,27 cases of gradeⅠ,33 cases of gradeⅡ,and 23 cases of gradeⅢin the IS group,and 25 cases of Weishaupt gradeⅠ,30 cases of gradeⅡ,and 30 cases of gradeⅢin the DS group.There was no significant difference in the degree of facet joint degeneration between the two groups(Z=-1.140,P=0.254).Conclusion:IS is similar to DS in the degeneration degree of intervertebral disc and facet joint,but the degree of spondylolisthesis and vertebral endplate degeneration is more severe in IS patients than in DS patients.

參考文獻(xiàn)/References:

[1] BYDON M,ALVI M A,GOYAL A.Degenerativelumbar spondylolisthesis:definition,natural history,conservative management,and surgical treatment[J].Neurosurg Clin N Am,2019,30(3):299-304.
[2] 李玉喬,方釗,張東亮,等.退變性及峽部裂性腰椎滑脫患者手術(shù)前后矢狀位參數(shù)與生活質(zhì)量相關(guān)性研究[J].中華醫(yī)學(xué)雜志,2022,102(3):228-234.
[3] BHALLA A,BONO C M.Isthmic lumbar spondylolisthe-sis[J].Neurosurg Clin N Am,2019,30(3):283-290.
[4] 魏見偉,陳龍偉,姜良海,等.退變性腰椎滑脫發(fā)病的相關(guān)因素探討[J].中國矯形外科雜志,2021,29(2):131-134.
[5] KOSLOSKY E,GENDELBER G D.Classification in brief:the meyerding classification system of spondylolisthesis[J].Clin Orthop Relat Res,2020,478(5):1125-1130.
[6] URRUTIA J,BESA P,CAMPOS M,et al.The Pfirrmann classification of lumbar intervertebral disc degeneration:an independent inter- and intra-observer agreement assess-ment[J].Eur Spine J,2016,25(9):2728-2733.
[7] UDBY P M,SAMARTZI S D,CARREON L Y,et al.A definition and clinical grading of Modic changes[J].J Orthop Res,2022,40(2):301-307.
[8] WEISHAUPT D,ZANETTI M,HODLER J,et al.MR imaging of the lumbar spine:prevalence of intervertebral disk extrusion and sequestration,nerve root compression,end plate abnormalities,andosteoarthritis of the facet joints in asymptomatic volunteers[J].Radiology,1998,209(3):661-666.
[9] 姜歡暢,王吉興,楊曉東,等.腰椎峽部裂發(fā)生的相關(guān)因素分析[J].中國臨床解剖學(xué)雜志,2019,37(5):583-585.
[10] 魏見偉,陳龍偉,姜良海,等.退變性腰椎滑脫發(fā)病的相關(guān)因素探討[J].中國矯形外科雜志,2021,29(2):131-134.
[11] 馬鈞峰,汪偉,王紫括,等.腰椎MRI評價椎間小關(guān)節(jié)積液與退變性腰椎滑脫穩(wěn)定性的相關(guān)性[J].中國組織工程研究,2019,23(24):3846-3851.
[12] 姚欣強(qiáng),程勇泉,鄭明輝,等.不同節(jié)段腰椎峽部裂對腰椎間盤退變程度的影響[J].中國矯形外科雜志,2017,25(9):785-789.
[13] 呂曉艷,石媛媛,關(guān)春爽,等.腰椎退變性滑脫與終板Modic改變的相關(guān)性研究[J].中國脊柱脊髓雜志,2015,25(5):400-404.
[14] 齊振熙,馬英鋒.退變性腰椎滑脫的三維有限元分析[J].中國骨傷,2004,17(12):714-716.
[15] 王普,孟祥祿,王建東,等.退變性與峽部裂性腰椎滑脫癥患者脊柱-骨盆復(fù)合體矢狀面形態(tài)學(xué)及生活質(zhì)量的比較[J].中國組織工程研究,2016,20(22):3322-3327.
[16] CLAESON A A,BAROCASV H.Computer simulation of lumbar flexion shows shear of the facet capsular ligament[J].Spine J,2017,17(1):109-119.
[17] 王偉,周紅海,陳龍豪,等.基于腰部多裂肌的生物力學(xué)和病理形態(tài)學(xué)研究探討腰部疾患的診治[J].中醫(yī)正骨,2022,34(6):53-56.
[18] 經(jīng)齊峰,沈水軍,董毅,等.腰椎退行性滑脫與棘間韌帶MRI的T2WI高信號相關(guān)性分析[J].中國骨傷,2021,34(4):333-336.
[19] FOURNIER D E,KISER P K,SHOEMAKER J K,et al.Vascularization of the human intervertebral disc:a scoping review[J].JOR Spine,2020,3(4):e1123.
[20] LOTZ J C,COLLIOU O K,CHIN J R,et al.Compression-induced degeneration of the intervertebral disc:an in vivo mouse model and finite-element study[J].Spine(Phila Pa 1976),1998,23(23):2493-2506.
[21] RISBUD M V,SHAPIRO I M.Role of cytokines in intervertebral disc degeneration:pain and disc content[J].Nat Rev Rheumatol,2014,10(1):44-56.
[22] GRIFFITH J F,WANG Y X,ANTONIO G E,et al.Modified Pfirrmann grading system for lumbar intervertebral disc degeneration[J].Spine(Phila Pa 1976),2007,32(24):E708-E712.
[23] LI R,WANG Z,MA L,et al.Lumbar vertebral endplate defects on magnetic resonance imaging in degenerative spondylolisthesis:novel classification,characteristics,and correla-tive factor analysis[J].World Neurosurg,2020,141:e423-e430.
[24] ZEHRA U,CHEUNG J,BOW C,et al.Multidimensional vertebral endplate defects are associated with disc degeneration,modicchanges,facet joint abnormalities,and pain[J].J Orthop Res,2019,37(5):1080-1089.
[25] 孫尚,趙振達(dá),蔣嬡,等.力學(xué)刺激在椎體軟骨終板退變中的作用及機(jī)制[J].醫(yī)用生物力學(xué),2021,36(4):652-657.
(收稿日期:2022-07-01 本文編輯:時紅磊)

相似文獻(xiàn)/References:

[1]徐幫杰,楊楠,白偉杰,等.坐位定點旋轉(zhuǎn)整復(fù)法治療腰椎間盤突出癥的療效觀察[J].中醫(yī)正骨,2015,27(11):17.
　XU Bangjie,YANG Nan,BAI Weijie,et al.Observation on the curative effect of fixed-point rotational reduction in sitting position in the treatment of lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):17.
[2]白春曉,賈育松,孫旗,等.中醫(yī)藥在腰椎間盤突出癥圍手術(shù)期應(yīng)用的研究進(jìn)展[J].中醫(yī)正骨,2015,27(11):65.
[3]王少純,周英杰.郭維淮教授運(yùn)用活血益氣通經(jīng)湯治療腰椎間盤突出癥的經(jīng)驗[J].中醫(yī)正骨,2015,27(11):75.
[4]鄧紅軍.硫酸鈣骨水泥椎體成形聯(lián)合后路短節(jié)段椎弓根螺釘 內(nèi)固定治療創(chuàng)傷性胸腰椎骨折[J].中醫(yī)正骨,2015,27(10):35.
[5]張莉,秦丹霞,張細(xì)姣.腹針治療椎間盤源性腰痛[J].中醫(yī)正骨,2015,27(10):38.
[6]蘇洪,張雪林.患側(cè)下肢牽引配合腰椎斜扳法治療 極外側(cè)型腰椎間盤突出癥[J].中醫(yī)正骨,2015,27(10):40.
[7]吳青坡,孫國紹,王林杰.后路椎管減壓聯(lián)合腰椎椎弓根釘動態(tài)穩(wěn)定裝置內(nèi)固定 治療單節(jié)段腰椎退行性疾病[J].中醫(yī)正骨,2015,27(10):42.
[8]謝冬群,黃中梁,葉金麗.加強(qiáng)隔附子餅灸治療腎陽虛型腰椎間盤突出癥的 臨床研究[J].中醫(yī)正骨,2015,27(09):18.
　XIE Dongqun,HUANG Zhongliang,YE Jinli.Clinical study on intensive aconite root cake separated moxibustion in the treatment of kidney-yang-deficiency-type lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):18.
[9]沈海良,錢萬鋒,周驍棟.針刀松解聯(lián)合局部封閉與口服中藥治療腰椎間盤突出癥[J].中醫(yī)正骨,2015,27(09):46.
[10]王仁燦,黃炎洪,潘偉江,等.45°肩踝懸吊牽引下撞擊腰椎療法治療L5S1椎間盤突出癥[J].中醫(yī)正骨,2015,27(08):51.
[11]賀振年,康信勇,徐洪偉,等.骨盆矢狀位參數(shù)對退行性腰椎滑脫癥的影響[J].中醫(yī)正骨,2015,27(06):19.
　HE Zhennian,KANG Xinyong,XU Hongwei,et al.Effect of pelvic parameters in the sagittal plane on degenerative lumbar spondylolisthesis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(02):19.
[12]吳群生.后路減壓椎弓根釘棒系統(tǒng)內(nèi)固定聯(lián)合椎間融合器植骨融合治療腰椎滑脫癥[J].中醫(yī)正骨,2016,28(11):30.
[13]步開東,曹燕,何建,等.后路椎弓根釘棒系統(tǒng)內(nèi)固定結(jié)合Cage椎間植骨融合術(shù)治療創(chuàng)傷性Ⅳ度腰椎滑脫[J].中醫(yī)正骨,2018,30(03):61.
[14]郭營,梅偉.后路減壓椎板骨或髂骨椎間植骨融合治療單節(jié)段重度腰椎滑脫癥[J].中醫(yī)正骨,2018,30(06):53.
[15]劉會文,陳緒林,曾景平,等.腰椎后路椎間自體骨移植Cage融合聯(lián)合萬向椎弓根螺釘內(nèi)固定治療腰椎峽部裂性滑脫[J].中醫(yī)正骨,2018,30(07):70.
[16]葉永勝,張雪飛,吳顯奎,等.減壓融合經(jīng)皮椎弓根螺釘與開放椎弓根螺釘內(nèi)固定手術(shù)治療腰椎滑脫的系統(tǒng)評價[J].中醫(yī)正骨,2018,30(12):40.
　YE Yongsheng,ZHANG Xuefei,WU Xiankui,et al.Decompression and fusion combined with percutaneous pedicle screw internal fixation versus open pedicle screw internal fixation for treatment of lumbar spondylolisthesis:a systematic review[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(02):40.
[17]張榮,張向東,趙明宇.平樂正骨筋滯骨錯理論在退行性腰椎滑脫癥診治中的應(yīng)用[J].中醫(yī)正骨,2019,31(04):61.
[18]王晟,呂立江,楊超,等.仰臥屈膝牽抖法治療退行性腰椎滑脫癥的生物力學(xué)作用機(jī)制[J].中醫(yī)正骨,2019,31(09):39.
[19]郭明偉,吳強(qiáng),林松,等.改良經(jīng)皮骨水泥椎間盤成形術(shù)治療高齡腰椎滑脫癥[J].中醫(yī)正骨,2022,34(06):77.
[20]吳紫燁,趙明宇,張向東,等.腰腹聯(lián)合療法治療退行性腰椎滑脫癥探析[J].中醫(yī)正骨,2022,34(08):67.

備注/Memo

備注/Memo:
基金項目:詹紅生2022年全國名老中醫(yī)藥專家傳承工作室建設(shè)項目(國中醫(yī)藥人教函〔2022〕75號); 上海市2020年度“科技創(chuàng)新行動計劃”醫(yī)學(xué)創(chuàng)新研究專項項目(20MC1920600); 上海市臨床重點專科建設(shè)項目(shslczdzk03901); 南通市衛(wèi)生和計劃生育委員會科研課題(QA2021025); 上海中醫(yī)藥大學(xué)附屬曙光醫(yī)院第二輪《促進(jìn)市級醫(yī)院臨床技能與臨床創(chuàng)新三年行動計劃》重大臨床研究項目(SHDC2020CR1051B) 通訊作者:詹紅生 E-mail:[email protected]
更新日期/Last Update: 1900-01-01