退变性腰椎滑脱软骨终板改变的影像学研究

摘要

Objective To study the relationship between degenerative lumbar spondylolisthesis and degeneration of cartilage endplate by magnetic resonance imaging.Methods The median sagittal scanning of LA/L5 and L5/S1 intervertebral discs of all subjects were performed by magnetic resonance imaging with T2.Measureed the inclination angle of the front half of the endplate and the inclination angle of the posterior half of the endplate,then the ratio of the anterior horn and the posterior horn was calculated as the change rate of the endplate.The differences of the rate of cartilage endplate in the corresponding stage of spondylolisthesis group and normal group were compared.Results In L4 lumbar spondylolisthesis group,both upper and lower endplate of L4/L5 intervertebral disc have significant differences between the lumbar spondylolisthesis group and the normal group (t =11.280,-3.765,P =0.000).In L5 lumbar spondylolisthesis group,there are significant differences between the lumbar spondylolisthesis group and the normal group (t =11.280,-3.765,P =0.000),both upper and lower endplate of L5/S1 intervertebral disc;and significant differences were found among the upper and lower endplates of the L5/S1 (t =4.633,P =0.000).Among all the subjects,between the upper and lower endplate of L4/L5,significant differences were found,too(t =17.377,3.137,2.199,P =0.000,0.005,0.035).In addition to the above,the differences were not statistically significant.Therefore,lumbar spondylolisthesis can lead to degenerative in cartilage endplate of Slippage stage.Conclusion The degree of degeneration of the anterior and the posterior half of the same cartilage endplate is asymmetrical,for example,the degeneration of the posterior half of the upper endplate is worse than that of the anterior half of the plate,but the degeneration of the anterior half of the lower endplate is worse than that of the posterior half endplate.The degenerative degree of cartilage endplate was less affected by lumbar spondylolisthesis in the non slip stage.%目的 通过磁共振成像研究退变性腰椎滑脱与软骨终板退变的关系.方法 对所有受检者的L4/L5、L5/S1椎间盘行正中矢状位T2加权磁共振扫描,测量每个软骨终板的前半倾角和后半倾角,计算出前半倾角与后半倾角的比值作为该终板的变异率.分别比较滑脱组与正常组对应阶段的软骨终板变异率的差异.结果 L4滑脱组:L4/L5椎间盘上、下终板与正常组之间差异均有统计学意义(t=11.280、-3.765,P=0.000).L5滑脱组:L5/S1椎间盘上、下终板与正常组之间差异有统计学意义(￡=3.736、-3.835,P=0.001、0.000);L5/S1椎间盘自身上、下终板之间差异有统计学意义(t=4.633,P=0.000).所有受检者中L4/L5椎间盘自身上、下终板之间差异有统计学意义(t=17.377、3.137、2.199,P=0.000、0.005、0.035).其余各对比差异均无统计学意义.结论 腰椎滑脱可致滑脱阶段软骨终板退变,且前、后半终板的退变程度不对称:椎间盘上终板的后半终板比前半终板退变严重,下终板的前半终板退变比后半终板严重;对非滑脱阶段软骨终板的退变无明显影响.