退变性腰椎侧凸的影像学和临床特点的相关性研究

摘要

Objective To observe radiological and clinical features of degenerative lumbar scoliosis,investigate theircor-relation and close degree,provide theoretical basis for prevention and treatment of degenerative lumbar scoliosis. Methods Ww used multipleline arregression to analyze the degenerative lumbar lateral convex(DLS)lumbocrural pain VAS scores and SRS-22 score and imaging parameters.Results a)Lumbago had significant correlation with the maximum lateral displace-ment、the stability of lumbar spine、foraminal area、lumbar lordosis. Leg pain had significant correlation with foraminal area、cone of vertebral rotation、the area of the spinal canal. Quality of life SRS-22 score had significant correlation with foraminal ar-ea、the stability of lumbar spine、the area of the spinal canal、lumbar lordosis the maximum lateral displacement and cone of vertebral rotation. b)On the basis of full decompression and stabilization of spine. Lumbago improvement rate had significant correlation with the rate of correction of the maximum lateral displacement and lumbar lordosis. Lower limb pain improvement rate had significant correlation with the rate of correction of cone of vertebral rotation and the lateral displacement. Quality of life SRS-22 score had significant correlation with the rate of correction of lumbar lordosis、cone of vertebral rotation and the lat-eral displacement.Conclusion a)Clinical symptoms have obvious correlation with the area of intervertebral foramen,thesta-bility of spinal,the degree of rotation Apical vertebra and the area of spinal and Lordosis angle. b)Surgery Decompression suffi-ciently,stabilizing the spine,restoring Lumbar lordosis angle,improving the degree of vertebra rotation and the maximum Later-al displacement are powerful guarantee to obtain good curative effect.%目的 通过观察退变性腰椎侧凸的影像学和临床特点,探讨二者的相关性及密切程度,为退变性腰椎侧凸的预防和治疗提供理论依据.方法 将退变性腰椎侧凸( degenerative lumbar scoliosis,DLS)腰腿痛视觉模拟评分( vis-ual analogue scale,VAS)和国际脊柱侧凸社会生活质量调查表( scoliosis research society-22,SRS-22)与影像学参数采用多元线性回归分析.结果 a)腰痛与相邻椎体的最大侧方位移、腰椎稳定性、椎间孔的面积、腰椎前凸角有显著相关性;下肢痛与腰椎间孔的面积、顶椎的椎体旋转度、椎管的面积有显著相关性;生活质量SRS-22评分与腰椎间孔的面积、腰椎的稳定性、椎管的面积、腰椎前凸角、椎体的侧方位移、顶椎的旋转度有显著相关性.b)在经充分减压,稳定脊柱的基础上,腰痛的改善率与腰椎最大的侧方位移和腰椎前凸角的矫正率有显著相关性,下肢痛的改善率与顶椎的旋转度和椎体的侧方位移的矫正率有显著相关性,生活质量SRS-22评分与腰椎前凸角、顶椎的旋转度和椎体的侧方位移的矫正率有显著相关性.结论 a)腰椎间孔的面积、腰椎的稳定性、顶椎的旋转度、椎管的面积、腰椎前凸角与临床症状有显著相关性.b)手术充分减压、稳定脊柱、恢复腰椎的前凸角、改善顶椎的旋转度和最大侧方位移是获得良好疗效的有力保障.