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目的:提高下腰椎关节突关节的异常改变对椎间盘突出症诊断的重要性的认识。材料与方法:随机抽取临床症状、体征及CT表现典型的腰椎间盘突出症病例的CT片1 0 0份,对该症发生的部位、类型进行统计;同时对关节突关节角进行测量并对关节角差值≥1 0°的进行按节段分类统计;对关节突关节面的形态和相互关系按4种类型进行分类。结果:单个椎间盘突出占6 8%,两个椎间盘同时突出占3 1 %,共计1 3 1个椎间盘突出发生于L3、4的1 7个占1 2 . 98%;L4、5的6 7个占5 1. 1 4 %;L5、S1的4 7个占3 5 . 88%。双侧关节突关节角不对称共有83个,占2 7. 6 7%,其中L3、4水平1 5个占1 8. 0 7%;L4、5水平3 8个占4 5 78%;L5、S1水平3 0个占3 6 . 1 4 %。双侧关节突关节形态不对称改变6 1个椎体,占2 0 .3 %。呈Ⅰ、Ⅱ型的最多,计3 4 1个,占94 .46 %,呈Ⅲ、Ⅳ型改变共计2 0个,其中1 6个发生于L5、S1水平,3个发生于L4、5水平。结论:关节突关节角小,不对称及关节面呈Ⅲ、Ⅳ型改变是腰椎间退变和突出症的潜在病因学因素之一,因此,提高对关节突关节的异常改变的认识在腰椎间盘突出症的诊断中至关重要
OBJECTIVE: To improve the understanding of the importance of the abnormal changes of the lower lumbar facet joint in the diagnosis of disc herniation. MATERIALS AND METHODS: One hundred and ten CT images of clinical symptoms, signs and CT typical lumbar disc herniation were randomly selected, and the location and type of the disease were statistically analyzed. At the same time, the joint angle was measured and the joint Angle difference ≥ 1 0 ° according to the classification of statistics; the morphology and correlation of the facet joint surface by 4 types of classification. Results: Single disc herniation accounted for 68%, while the two disc herniation accounted for 31% at the same time, a total of 1 3 1 disc herniation occurred in L3,4 1 2 accounted for 98.2%; L4,5 6 7 Accounting for 5.14%; L5, S1, 47 accounted for 35.88%. There were 83 asymmetric bilateral joint angles, accounting for 27.67%, of which L3.4 levels accounted for 18.07%, L4,5 levels 38/4788 and L5 , S1 level 30 accounted for 36.414%. Unilateral asymmetry of the bilateral joint changes in 6 1 vertebral body, accounting for 20.3%. There were 341, accounting for 94.46% of the total of type I and type II, with a total of 20 changes of type III and type IV, of which 16 occurred at L5 and S1 levels and 3 at L4 and 5 levels . CONCLUSIONS: The small, asymmetrical facets of articular process and III and IV changes of articular surface are one of the potential etiological factors of lumbar intervertebral disc degeneration and protrusion. Therefore, it is necessary to improve the understanding of abnormal changes of articular process in lumbar intervertebral disc The diagnosis of prominence is crucial