南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (09): 1303-.

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胸腰段陈旧性压缩性骨折患者椎体变形与相邻椎间盘退变的相关性

崔运能,李绍林,赵银霞,岑黄   

  • 出版日期:2015-09-20 发布日期:2015-09-20

Correlation of vertebral body deformity and adjacent disc degeneration in patients with
old thoracolumbar compression fractures

  • Online:2015-09-20 Published:2015-09-20

摘要: 目的探讨胸腰段陈旧性压缩性骨折患者椎体变形与相邻椎间盘退变的相关性。方法回顾性分析2011年4月~2014年5
月到本院就诊陈旧性压缩性骨折并仅行保守治疗的患者资料,均行X线及MRI检查,共71名患者;在X线平片上利用Genant半
定量标准评估受累椎体的形态学改变,在MR图像上观察受累椎体相邻头侧、尾侧椎间盘的形态、信号变化,并进行Oner 及
Pfirrmann分级评分;对受累的变形椎体,与相邻椎间盘的形态、信号改变进行相关性分析;并比较受累椎体相邻头侧、尾侧椎间
盘的形态、信号改变。结果椎体变形Genant分度与相邻头侧椎间盘的Oner形态学改变分度具有中等程度的相关性(r=0.48,
P<0.01),但与相邻头侧椎间盘的Pfirrmann分级、相邻尾侧椎间盘的Oner分度、Pfirrmann分级无明显相关性(P>0.05),变形椎
体相邻头侧的椎间盘Oner分度较相邻尾侧椎间盘高(P<0.01),但两组椎间盘的Pfirrmann分级无明显差异(P>0.05)。结论胸
腰段椎体压缩性骨折主要影响相邻头侧椎间盘的形态,两者严重程度相一致,而相邻尾侧椎间盘不受影响。

Abstract: Objective To assess the correlation between vertebral body deformity and degeneration of the adjacent intervertebral
discs in patients with old thoracolumbar compression fractures. Methods Seventy-one patients who had been conservatively
treated after single segment thoracolumbar compression fractures between April, 2011 and May, 2014 were enrolled in this
study. Both radiographic and magnetic resonance (MR) images of the thoracolumbar segment were obtained. The involved
vertebral body deformity was rated on radiography according to the Genant criterion, and the degeneration of the adjacent
cephalic and caudal discs was assessed on MR images using the Oner and Pfirrmann classification schemes, respectively. The
relationship between vertebral body deformity and adjacent disc changes was assessed using correlation analysis, and the
changes in the adjacent cranial and caudal discs was compared. Results The Genant classification of the involved vertebral
bodies was moderately correlated with Oner morphological scores (r=0.48, P<0.01), but not with the Pfirrmann signal scores of
the adjacent cephalic discs or with the Genant or Pfirrmann scores of the adjacent caudal discs (P>0.05). The Oner classification
of the adjacent cephalic discs was higher than that of the adjacent caudal discs (P<0.01), but their Pfirrmann classification did
not differ significantly. Conclusion The deformity of vertebral body affects the adjacent cephalic discs proportionally but not
the adjacent caudal discs.