| Background and objective:Adolescent lumbar disc herniation is a special type of lumbar disc herniation.In recent years,with the popularization of precision medicine,the improvement of parents' health awareness,the rise of the incidence of obesity among teenagers and the increase of schoolwork and work pressure,the incidence of lumbar disc herniation among teenagers has been gradually increasing.It was previously believed that the occurrence of lumbar disc herniation in adolescents was related to obesity,trauma,thickness of yellow ligament,genetic factors,lumbosacral structural abnormalities and many other factors.In recent years,many scholars have observed the occurrence of abnormal facet joint and ALDH are closely related,and the related research have been done,but at the moment the results of the study on the relationships between facet joints and adolescent lumbar intervertebral disc are still controversial because of the different inclusion criteria,measurement methods and inconsistent definition and many other factors.In this study,we investigated the relationships between facet joint orientation(FJO)and ALDH,facet joint asymmetry(FT)and ALDH by measuring and comparing the lumbar facet joint angles in 44 adolescent patients with lumbar disc herniation and 41 adolescent patients with acute abdomen without spine-related diseases.Methods:A total of 44 cases of adolescent patients with lumbar disc herniation and 41 cases of adolescent patients with appendicitis,pancreatitis and cholecystitis who were diagnosed and treated with surgery in China-Japan Union Hospital of Jilin University from December 2013 to December 2019 were selected.The facet joint angle and pedicle-facet angle at L1~2?L2~3?L3~4?L4~5?L5~S1 segment were measured and recorded by lumbar CT and abdominal CT,respectively,and the angle difference between the two facet joints ?7° was defined as the facet joint tropism(FT)to analyze the relationship between facet joint orientation,facet tropism and ALDH.All the measured results were analyzed with SPSS 23.0 software,and P < 0.05 was considered as statistically significant.Results:1.Compared with the control group,the facet joint angles of L1~ L2 and L2~L3 segment in the ALDH group were not statistically significant;The facet joint angles of L3~L4,L4~L5 and L5~S1 segments of ALDH group were smaller than the control group with statistically significant differences.2.Compared with the control group,the P-F angles of L1~L2 and L2~L3 segments in the ALDH group were not statistically significant;The P-F angles of L3~L4,L4~L5 and L5~S1 in the ALDH group were larger than the control group with statistically significant differences.3.Compared with the control group,there were no statistical difference on the incidence of FT of L1~L2 and L2~L 3 segment in the ALDH group;The incidence of FT of L3~L4,L4~L5 and L5~S1 segments in the ALDH group were higher than the control group with statistically significant differences.4.The corresponding segmental facet joint angle of the ALDH patients at L4~L5 level(N = 25)was smaller than the control group(N = 41);The P-F angle was larger than the control group,and the incidence of FT was significantly higher than the control group with statistically significant differences.5.The corresponding segmental facet joint angle of the ALDH patients at L5~S1 level(N = 20)was smaller than the control group(N= 41);The P-F angle was larger than the control group,and the incidence of FT was significantly higher than the control group with statistically significant differences.Conclusion:1.Sagittal changes of lower lumbar facet joints are associated with ALDH patients.2.The lateral changes of the pedicle-facet angle of the lower lumbar spine are associated with ALDH patients.3.Lower lumbar facet joint tropism is associated with ALDH and may be one of the risk factors for ALDH. |
PDF Full Text Request