CAJ | 학술논문

背景:近年来,有关生物力学因素与腰背痛关系的报道大多集中在腰椎整体生物力学与腰背痛的研究上,而针对局部生物力学特点与单纯腰椎间盘突出的研究则较少.目的:探讨局部生物力学因素在L_5/S_1 椎间盘突出症发病中的作用.方法:共纳入对象124例,包括椎问盘突出症组和对照组,62例/组.椎间盘突出症组为2008-06/2009-07于青岛大学医学院附属医院诊断明确并行手术治疗的L5/S_1 椎间盘突出症患者;对照组为健康体检人员.在腰椎正侧位X射线片上测量和观察各组L_5椎体相对深度、腰骶移行椎、L_5/S_1 椎间盘相对高度、腰骶角、骶骨水平角和骶骨垂直角的变化.结果与结论:与对照组比较,椎间盘突出症组L_5椎体相对深度明显增加(P<0.01),椎间盘突出症组腰骶移行椎数目明显降低(P<0.01),说明相对位置较深的L_5椎体及腰骶移形椎可能对L_5/S_1 椎间盘具有保护作用,可降低L_5/S_1椎间盘突出症的发生率.椎间盘突出症组腰骶角和骶骨水平角明显减小(P<0.01);但L_5/S_1骶骨垂直角和椎间盘相对高度在椎间盘突出症组与对照组之间差别无显著性意义(P>0.05),可见,L_5/S_1椎间盘相对高度、腰骶角、骶骨水平角和骶骨垂直角与椎间盘突出的关系仍不明确,需进一步探讨.
배경:근년래,유관생물역학인소여요배통관계적보도대다집중재요추정체생물역학여요배통적연구상,이침대국부생물역학특점여단순요추간반돌출적연구칙교소.목적:탐토국부생물역학인소재L_5/S_1 추간반돌출증발병중적작용.방법:공납입대상124례,포괄추문반돌출증조화대조조,62례/조.추간반돌출증조위2008-06/2009-07우청도대학의학원부속의원진단명학병행수술치료적L5/S_1 추간반돌출증환자;대조조위건강체검인원.재요추정측위X사선편상측량화관찰각조L_5추체상대심도、요저이행추、L_5/S_1 추간반상대고도、요저각、저골수평각화저골수직각적변화.결과여결론:여대조조비교,추간반돌출증조L_5추체상대심도명현증가(P<0.01),추간반돌출증조요저이행추수목명현강저(P<0.01),설명상대위치교심적L_5추체급요저이형추가능대L_5/S_1 추간반구유보호작용,가강저L_5/S_1추간반돌출증적발생솔.추간반돌출증조요저각화저골수평각명현감소(P<0.01);단L_5/S_1저골수직각화추간반상대고도재추간반돌출증조여대조조지간차별무현저성의의(P>0.05),가견,L_5/S_1추간반상대고도、요저각、저골수평각화저골수직각여추간반돌출적관계잉불명학,수진일보탐토.
BACKGROUND:The relationship between biomechanical factors and low back pain has been extensively studied in recent yearst,but mostly focus on unitary biomechanics characters and low back pain.There are few studies with regard to partial biomechanical factors and L_5/S_1 disc herniation.OBJECTIVE:To explore the role of biomechanical factors in pathogenesis of L_5/S_1 disc herniation.METHODS:Totally 124 cases were included in the study All cases were divided into the disc herniation group and controI groups,with 62 cases in each group.The disc herniation group consisted of L_5/S_1 herniation patients received treatment at the Affiliated Hospital of Medical College of Oingdao University,and the healthy examination cases were served as controls.The Indicator included relative depth of lumbar 5 vertebra,lumbosacral transitional vertebra,relative height of L_5/S_1 disc,lumbosacral angle,sacral horizon angle and sacrallnclination angle.The difference of the indicators between the two groups was analyzed statistically.RESULTS AND CONCLUSION:The relative depth of L_5 vertebra of the disc heniation group was significantly higher than the control group(P<0.01),and the number of lumbosacral transitional vertebra of disc heniation group was significantly fewer than the control group(P<0.01),which indicated that the deep-seated lumbar 5 vertebra and lumbosacral transitional vertebra might protect L_5/S_1 disc and reduce the incidence of L_5/S_1 disc herniation.Lumbosacral angle and sacral horizon angle of disc herniation group were significantly lower than that of control group(P<0.01),but there was no significant statistical sense in the difference of sacral inclination angle between the two groups(P>0.05),and there was no significant statistical sense in the difference of relative height of L_5/S_1 disc(P>0.05),which indicated the roles of relative height of L_5/S_1 disc,lumbosacral angle,sacral horizon angle and sacralinclination angle in L_5/S_1 disc herniation still need further study.