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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2017, Vol. 14 ›› Issue (01) : 40 -44. doi: 10.3877/cma.j.issn.1672-6448.2017.01.011

所属专题： 文献；

骨骼肌肉超声影像学

超声评估腰椎关节突关节的可行性研究
黄瑛1,†(), 田丹1, 柳达2, 尹晶1, 于秋爽1   
  1. 1. 110004　沈阳，中国医科大学附属盛京医院超声科
    2. 110004　沈阳，中国医科大学附属盛京医院骨科
  • 收稿日期:2015-12-12 出版日期:2017-01-01
  • 通信作者: 黄瑛
  • 基金资助:
    国家自然科学基金资助项目(81371552)

Ultrasounographic assessment of facet joint in the lumbar spine: a feasibility study

Ying Huang1,†(), Dan Tian1, Da Liu2, Jing Yin1, Qiushuang Yu1   

  1. 1. Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, China
    2. Department of Orthopaedic Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
  • Received:2015-12-12 Published:2017-01-01
  • Corresponding author: Ying Huang
  • About author:
    Corresponding author: Huang Ying, Email:
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引用本文：

黄瑛, 田丹, 柳达, 尹晶, 于秋爽. 超声评估腰椎关节突关节的可行性研究[J]. 中华医学超声杂志（电子版）, 2017, 14(01): 40-44.

Ying Huang, Dan Tian, Da Liu, Jing Yin, Qiushuang Yu. Ultrasounographic assessment of facet joint in the lumbar spine: a feasibility study[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(01): 40-44.

目的

对比正常与退变腰椎小关节的超声与CT测值，评价采用超声评估腰椎小关节的可行性。

方法

选取2014年1月至2015年12月在中国医科大学附属盛京医院进行检查慢性腰痛患者15例，作为慢性腰痛患者组，选取本院体检中心健康志愿者19人作为健康对照组。分别测量正常与异常腰椎L1-S1各个小关节的超声与CT测值（长度与宽度），对健康对照组L1-S1各个小关节左右侧超声测量长度与宽度，健康对照组与慢性腰痛患者组的超声测值、超声与CT测值进行t检验。

结果

超声能够清晰地显示异常的小关节病变，表现为关节边缘骨质增生，关节下骨质破坏，关节软骨磨损或病变而变薄或增厚。对于腰椎小关节的长度与宽度，正常与异常腰椎小关节的超声测量值之间均值长度的比较，差异有统计学意义[（1.26±0.03）cm vs（1.43±0.05）cm，t=2.626，P<0.05]；均值宽度的比较，差异有统计学意义[（0.18±0.01）cm vs（0.15±0.02）cm，t=2.264，P<0.05]。患者组15例，共150个小关节，超声与CT 2种检查方法所得测值之间均值长度比较，差异无统计学意义[（1.43±0.17）cm vs （1.42±0.16）cm，t=1.655，P>0.05]，宽度比较，差异无统计学意义[（0.15±0.03）cm vs （0.14±0.03）cm，t=1.656，P>0.05]。

结论

超声可清晰显示腰椎小关节的结构，对于腰椎小关节退变的诊断具有一定意义。

关键词: 腰椎, 超声检查, 可行性研究, 腰痛
Objective

To assess the feasibility and accuracy of ultrasound evaluation of facet joint in the lumbar spine by comparison of ultrasonography and CT measurements in normal and degenerative lumbar vertebra small joint.

Methods

Fifteen patients with chronic low back pain in Shengjing hospital of China Medical University were taken as the study group ,and 20 healthy volunteers as the healthy controls from physical examination center of our hospital between January 2014 and December 2014. The ultrasonic and CT values were measured in L1 - S1 small joints between normal and abnormal lumbar joints (height and width). The length and width of the left and right side small joints of healthy controls, ultrasonic measurement of healthy controls and patients with chronic low back pain, and value of ultrasonography and CT measurements were compared by using t test.

Results

The abnormal facet joint can be clearly showed by sonography, characterized by bone hyperplasia of edge joints, bone destruction, wear or thinning/thickening of articular cartilage. For the length and width of the lumber joints, the difference of ultrasonic measurement values between normal and abnormal lumbar joints were statistically significant [(1.26±0.03) cm vs (1.43±0.05) cm, t=2.626, P<0.05; (0.18±0.01) cm vs (0.15±0.02) cm, t=2.264, P<0.05]. In patient group, the difference of length and width values in a total of 150 small joints between ultrasonography and CT were not statistically significant [(1.43±0.17) cm vs (1.42±0.16) cm], t=1.655, P>0.05; (0.15±0.03) cm vs (0.14±0.03) cm, t=1.656, P>0.05].

Conclusions

The facet joint of the lumbar can be clearly shown by sonography and it is valuable in the diagnosis of small joint degeneration for lumbar vertebra.

Key words: Lumbar vertebrae, Ultrasonography, Feasibility studies, Low back pain
图7，8 异常小关节的旁矢状面超声图（图7）及CT图（图8），下关节突骨质破坏，关节面连续中断
表1 健康对照组与慢性腰痛患者组正常腰椎小关节超声测值比较（cm，±s）
组别 关节个数 关节长度 关节宽度
健康对照组 190 1.26±0.03 0.18±0.01
慢性腰痛患者组 150 1.43±0.05 0.15±0.02
t值 ? 2.626 2.264
P值 ? <0.05 <0.05
表2 慢性腰痛患者组小关节的超声与CT测量值之间的比较（cm，±s）
组别 关节个数 关节长度 关节宽度
超声测量值 150 1.43±0.17 0.15±0.03
CT测量值 150 1.42±0.16 0.14±0.03
t值 ? 1.655 1.656
P值 ? >0.05 >0.05
[1]
Kalichman L, Hunter DJ. Lumbar facet joint osteoarthritis: a review [J]. Semin Arthritis Rheum, 2007, 37(2):69-80.
[2]
Manchikanti L, Boswell MV, Singh V, et al. Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions [J]. BMC Musculoskelet Disord, 2004, 5:15.
[3]
Eubanks JD, Lee MJ, Cassinelli E, et al. Prevalence of lumbar facet arthrosis and its relationship to age, sex, and race: an anatomic study of cadaveric specimens [J]. Spine (Phila Pa 1976), 2007, 32(19):2058-2062.
[4]
Kalichman L, Li L, Kim DH, et al. Facet joint osteoarthritis and low back pain in the community-based population [J]. Spine (Phila Pa 1976), 2008, 33(23):2560-2565.
[5]
Goode AP, Carey TS, Jordan JM. Low back pain and lumbar spine osteoarthritis: how are they related? [J]. Curr Rheumatol Rep, 2013, 15(2):305.
[6]
Manchikanti L, Singh V. Review of chronic low back pain of facet joint origin [J]. Pain Physician, 2002, 5(1):83-101.
[7]
Liu D, Huang Y, Tian D, et al. Quantitative ultrasound assessment of facet joint in the lumbar spine: a feasibility study [J]. Ultrasound Med Biol, 2015, 41(5):1226-1232.
[8]
Pampati S, Cash KA, Manchikanti L. Accuracy of diagnostic lumbar facet joint nerve blocks: a 2-year follow-up of 152 patients diagnosed with controlled diagnostic blocks [J]. Pain Physician, 2009, 12(5):855-866.
[9]
Gore M, Sadosky AB, Leslie DL, et al. Therapy switching, augmentation, and discontinuation in patients with osteoarthritis and chronic low back pain [J]. Pain Pract, 2012, 12(6):457-468.
[10]
高峰，汤健，石志才, 等. 腰椎小关节病变在腰痛中的作用: 附516例前瞻性研究[J]. 第二军医大学学报, 2004, 25(12):1360-1363.
[11]
Loizides A, Gruber H, Peer S, et al. Ultrasound guided versus CT-controlled pararadicular injections in the lumbar spine: a prospective randomized clinical trial [J]. AJNR Am J Neuroradiol, 2013, 34(2):466-470.
[12]
Aguirre DA, Bermudez S, Diaz OM. Spinal CT-guided interventional procedures for management of chronic back pain [J]. J Vasc Interv Radiol, 2005, 16(5):689-697.
[13]
欧阳林，徐玉琴，郏潜新, 等. 下腰椎小关节退行性病变的X线、CT、MRI影像学比较[J/CD]. 中华临床医师杂志(电子版), 2009, 3(4):658-664.
[14]
金胡日查，崔志明. 腰椎关节突关节退变的影像学研究进展[J/CD]. 中华临床医师杂志(电子版), 2013, 7(8):3577-3579.
[15]
Stehling C, Lane NE, Nevitt MC, et al. Subjects with higher physical activity levels have more severe focal knee lesions diagnosed with 3T MRI: analysis of a non-symptomatic cohort of the osteoarthritis initiative [J]. Osteoarthritis Cartilage, 2010, 18(6):776-786.
[16]
Tarhan S, Unlu Z. Magnetic resonance imaging and ultrasonographic evaluation of the patients with knee osteoarthritis: a comparative study [J]. Clin Rheumatol, 2003, 22(3):181-188.
[17]
Klukowska A, Czyrny Z, Laguna P, et al. Correlation between clinical, radiological and ultrasonographical image of knee joints in children with haemophilia [J]. Haemophilia, 2001, 7(3):286-292.
[18]
叶乐，郑拥军，朱紫瑜, 等. 超声引导下射频损毁腰脊神经后内侧支治疗腰椎小关节综合征[J]. 上海医学, 2012, 35(6):476-479.
[19]
文传兵，李永忠，汤芹芹, 等. 超声探测腰椎小关节的可行性和准确性研究[J]. 四川大学学报(医学版), 2013, 44(2):300-302.
[20]
Masharawi Y, Rothschild B, Dar G, et al. Facet orientation in the thoracolumbar spine: three-dimensional anatomic and biomechanical analysis [J]. Spine (Phila Pa 1976), 2004, 29(16):1755-1763.
[21]
付文芹，吴小涛，祁亚斌, 等. 腰椎小关节退变致腰腿痛机制的实验研究[J]. 中国脊柱脊髓杂志, 2006, 16(6):446-449.
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