| Objective: Degenerative lumbar scoliosis(DLS) had a complex cause, a relative longer course and resulted in some unsymmetry lesion in grandul advancement, including the inteval unsymmetry marrow, the vertebral wedge-shape and the unsymmetry direction of facet joint. This unsymmetry bony construction changes was not only the result of unsymmetry load resulted as DLS, but also was factor the advancement of DLS. the study of relation between unsymmetry bony change and DLS was less at present. In the study of relation between intervertebral disc degeneration and DLS, its close relation was knowed but its mechanism and process not knowed maybe because of the ignored endplate degeneration. The cartilage endplate of vertebral body was a part of intervertebral disc and played significant roles at construction and function. The bony endplate of vertebral body was a nutrient passage of intervertebral disc by connecting adjacent intevertebral disc. So the endplate degeneration easily resulted in the bony structural change of intervertebral place and vertebral body. In this study, the intervertebral disc and endplate regarded as a function entirety, to analyse the relationship of between unsymmetry bony structural parameter, lumbar scoliosis angle and lumbar lordosis angle. To disclose the role of intervertebral disc-endplate degeration and unsymmetry bony structural parameter in DSL, to provide some theory of prevention and treatment for DLS.Method: The imaging data of 120 patients who diagnosed primary degenerative lumar scoliosis in our hospital from Dec. 2008 to Dec. 2010 ,including 47 male and 73 female aged 50～77 years old(average 61.5 years old) were retrospectively reviewed as the case group. The imaging data of 89 patients who diagnosed lumbar degenerative disease excluding lumbar scoliosis were selected as the control group . the two group meet same time period, same age period and same sex ratio, and all cases were performed X-ray, CT and MRI. The vertebral body, intervertebral disc and adjacent endplate of main curve in case group but L1～L4 in control group were selected as the observed object. The measurement of vertebral and intervertebral height of both sides on frontal X-ray, the measurement of facet joint sagittal angle of both sides on CT were performed. The vertebral average height, intervertebral average height and facet average sagittal angle of both sides were regarded as bony structural parameter to undertake pairiong t-test, if the difference of both sides had statistical significance, the difference value of both sides was described as the asymmetry degree. The lumbar scoliosis angle and lumbar lordosis angle were measured in case group. The quantitative grading methods were used in the intervertebral disc and endplate degeneration, and the scoring was conincident with its degeneration degree. The correlation between intervetebral disc-endplate degeneration and asymmetric bony structural parameter, the relationship of asymmetric bony structural parameter, lumbar scoliosis angle and lumbar lordosis angle were analyzed through the comparision of bony structural parameter between the case group and the control group.Result: by t test, the difference of bony sturctural parameter between convex and concave side in case group had statistical significance(P<0.05), but in control group that of both sides had no statistical significance(P>0.05).The difference of body sturctural parameter between one side in control group and convex side in case group had no statistical significance(P>0.05), but the difference between one side in control group and concave side in the case group had statistical significance(P<0.05). By correlative analysis, the scoring of intervertebral disc-endplate degeneration had good correlativity with each of bony sturctural parameter(P<0.05). The asymmetric bony sturctural parameter showed positive correlation with the lumbar scoliosis angle(0 |
PDF Full Text Request