| Objective:To investigate the clinical characteristics of posterior rim separation of vertebrae and explore the correlation between the posterior margin of vertebral body and lumbar degeneration.Methods:The objects,hospitalized from January 1st 2015 to January30th 2018,were selected from the department of orthopedics of the affiliated hospital of sichuan north medical college.During hospitalization,the lumbar CT,lumbar orthotopic X-ray and lumbar magnetic resonance examination were performed on the objects to exclude the admission of trauma,tumor,inflammation and spinal deformity.A total of 972 patients,in which 562patients had operations consisting of 458 males and 514 females;The average age of men aged 16 to 82 is 43,and the average age of women is 45.5 years.According to the CT manifestations of lumbar vertebra,the occurrence of the posterior margin of the vertebral body was recorded,and the lumbar segment and type of the posterior margin of the vertebral body were separated.According to lumbar X-ray,using Farfan method to assess the changes of lumbar intervertebral space.Lumbar spondylolisthesis diagnosis based on lumbar X-ray and Meyerding method for indexing;According to the Pfirrmann method to analysis the degree of lumbar disc herniation and pathological classification;In lumbar MRI sagittal and transverse sections to assess the presence or absence of lumbar spinal stenosis and lumbar Modic changes.The data obtained using statistical software SPSS17.0 for processing.Analyze the incidence of posterior rim separation of vertebrae and the distribution of posterior rim separation of vertebrae in lumbar segments,gender and age.And we discussed the correlation with gender,age,lumbar segmental degeneration and lumbar spine(herniation,spinal canal stenosis and lumbar olisthe,Modic changes).The differences between the data was examined though chi-square test,and the comparison of data correlation was examined though rank correlation.P?0.05 was statistically significant.Results:A total of 972 patients,52 cases(including 48 surgery cases)in vertebral rear is broken,consisting of?10 cases,?26 cases,?16 cases.The vertebral bodies in this group were single,and 1 case after L2.2 cases after L3.There were 9 cases in L4,including 3 in L4 and 6 in the lower margin of L4.There were 22 cases of L5 vertebral bodies,10 cases after L5,and 12 cases after L5.18 cases after S1.Intervertebral disc segment:30 cases in L5/S1,16 in L4/L5,5 in L3/L4,and 1 in L2/L3.The incidence rate was0.62%,0.33%,0.10%and 0.02%respectively.(using chi-square test,X~2=61.786,P=0.000,P<0.05,with statistical difference.)Gender difference:female incidence:4.28%(22/514),male incidence rate:6.55%(30/458),whether there was statistical significance(P=0.116,P>0.05).In different age groups,the incidence of posterior border separation was26.92%among 15-24-year-olds.The incidence of posterior rim separation of vertebrae was 27.27%in 25~34 groups.The incidence of posterior rim separation of vertebrae was 10.63%in the 35~44 group.The incidence of posterior rim separation of vertebrae was 3.25%.The incidence of pposterior rim separation of vertebrae was 2.43%in the 55-64 group.The incidence of posterior rim separation of vertebrae was 0 in 65~74 and 75~84 group.(Correlation analysis was based on rank correlation,correlation coefficient rs=-0.955,P=0.001,P<0.05).A total of 344 patients with no obvious degeneration of lumbar disc,of which 6 cases of posterior rim separation of vertebrae;There are 299 cases of lumbar disc bulging,including 8 cases of posterior rim separation of vertebra.A total of 226 cases of lumbar disc herniation,including 20 cases of posterior rim separation of vertebrae.A total of 85 cases of prolapse of the lumbar disc,including posterior rim separation of vertebra in 18 cases.The incidence of posterior rim separation of vertebra in the normal of lumbar disc,bulging,lumbar disc herniation,and prolapse of lumbar disc were 1.74%,2.68%,8.85%and 17.48%respectively.38 cases of the posterior margin of the vertebral body was found in the total cases of protrusion and exogenous pathology,accounting for 73.08%.which also accounts for 26.92%out of the normal and bulging lumbar disc.(X~2=48.431,P=0.000,P<0.05,and the difference was statistically significant.)In this group of data there are 116 cases of obvious lumbar spinal stenosis,of which 24 cases of posterior rim separation of vertebra,the incidence was 20.69%.The incidence of posterior rim separation of vertebra in the absence of lumbar spinal stenosis was 3.27%.(X~2=61.212,P=0.000,P<0.05,and the difference was statistically significant.)The distribution of Spondylolisthesis:the incidence of Spondylolisthesis group was 5.26%(5/95),the incidence of none-lumbar olisthe group was5.36%(47/877),two differences have no obvious statistical significance(P=1.000,P>0.05)The incidence of the change of Modic in posterior rim separation of vertebra was 11.03%(15/136),and the incidence of none-Modic change group was 4.43%(37/836).The difference was statistically significant(P=0.002,P<0.05).The incidence of posterior rim separation of vertebra with normal intervertebral space was 2.74%,and the incidence of posterior rim separation of vertebra was 10.79%in patients with intervertebral space changes.The two differences were statistically significant(P=0.000,P<0.05).Conclusion:1.L5 and S1 are the most commonly affected vertebral bodies at the posterior rim separation of vertebra,and it is most commonly found in L5/S1 and L4/L5 segments,which is consistent with the common segment of lumbar intervertebral disc herniation.2.There are no significant difference of incidence between men and women in the posterior rim separation of vertebra.And occurrence tends to be at the young age of people.3.The posterior rim separation of vertebra,within a certain period of time,does not significantly lead to the occurrence of lumbar spondylolisthesis.4.The occurrence of posterior rim separation of vertebra was associated with degeneration of intervertebral discs,changes in intervertebral space,lumbar spinal stenosis and Modic changes. |
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