The Relationship Between The Lumbar Disc Herniation With The Change Of Zygapophysial Joints Angle Measured By MRI

Objective:To analyze the relationship between the lumbar disc herniation with the change of zygapophysial joints angel measured by MRI.Analyzing the causes of lumbar disc herniation from the anatomy and morphology of the spine,and providing evidence for early diagnosis and prevention of lumbar disc herniation.Methods: Choose 650 patients were treated in the department of spinal surgery of liuzhou people’s hospital,from Jan.2014 to Dec.2017.The main clinical diagnosis is lumbar disc herniation,and the lumbar vertebra MRI showed lumbar disc herniation of single segment(L4/5 or L5/S1).Through the filtration of inclusion and exclusion criteria,data measurement requirements,390 cases were eventually included,and 115 cases had the lumbar vertebra CT as well as.Depending on the different types of disc herniation,departed then into three experimental groups:130 cases in the central LDH group,133 in the left lateral LDH group and127 in the right lateral LDH group.Collected 70 Health examination cases whose lumbar vertebra MRI showed no disc herniation as the control group.According to the international general method,two spine surgeons adopted the angle value of right,left facet joint(α,β)in the segments of L3/4,L4/5,L5/S1 in each group by double-blind measure,then recorded the average value of them adopted as the final angle value.Definited(α+β)as the value of facet joint inclined angle was γ,the absolute value of angular difference of the right with left joint ∣α-β∣>10° as lumbar zygapophyseal joints asymmetry.Using the SPSS19.0to compare the differences of angle value of facet joint measured by MRI and CT.To campare the differences of the values of α,β in the L3/4,L4/5,L5/S1 segments in every group,the differences of the values of α,β,∣α-β∣in the L3/4,L4/5,L5/S1 segments between the each experimental group with control group.To analyzed the relationship between LDH with lumbar zygapophyseal joints asymmetry.To analyze the correlation between the value of α,β,∣ α-β ∣,γ with age in the pathological segments in each experimental group,then drew relevant conclusionsResults:(1)The difference between the angle values of the facet joints measured by MRI and CT was statistically significant(P >0.05).⑵In the pathological segments of L4/5,L5/S1 in the left,right lateral LDH groups,the difference between α with β was statistically significant.The facet joint value of disc herniated side was smaller than offside.There was no statistically significant difference between α with β in adjacent segments of LDH segments(P>0.05).There was no statistically significant difference betwwen α with β in the segments of L3/4,L4/5,L5/S1 in the central LDH group(P>0.05).⑶ The difference was statistically significant in α,β between pathological segments of L4/5,L5/S1 in the left,right lateral LDH group with the same segment of control group,the facet joint value of disc herniated side was smaller than normal,but the value of offside facet joint was larger than normal(P<0.05).Compared with the same segment of control group,the value of α,β in pathological segments of L4/5,L5/S1 in the central LDH group was smaller than that in the same segment of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in α,β of adjacent segments of LDH segments between the experimental groups with control group.⑷ The difference was statistically significant in ∣α-β∣ between pathological segments of L4/5,L5/S1 in the left,right lateral LDH group with the same segment of control group,the value of ∣α-β∣was significantly larger than the control group(P<0.05).There was no statistically significant difference in∣α-β∣between pathological segments of L4/5,L5/S1 in the central LDH group with the same segment of control group(P>0.05).There was no statistically significant difference in ∣α-β∣of adjacent segments of LDH segments between the experimental groups with control group(P>0.05).⑸ The difference was statistically significant in the proportion of facet tropism between the pathological segments of L4/5,L5/S1 with its adjacent segments in the left,right lateral LDH groups(P<0.05).There was no statistically significant difference in the proportion of facet tropism between the pathological segments with its adjacent segments in the central LDH group(P>0.05).⑹ There was no correlation between the age with the values of α,β,γ,∣α-β∣of pathological segment in the experimental groups(P>0.05),the scatter diagram showed there was no linear correlation between the indicators above with the age.Conclusion:⑴ MRI has a high sensitivity to measure the angle of facet joint,which can be used to study the correlation between the angle change of lumbar facet joint with the lumbar disc herniation.⑵The facet tropism was closely related to the latral lumbar disc herniation,could be one of the factors that causes the latral LDH,the LDH was more occurred in the slant sagittal facet joint,the facet joint angle of LDH was more sagittal change.⑶There was no correlation between the facet tropism with the central lumbar disc herniation,the facet joint angle of central LDH was more sagittal change than normal.