背景:研究的目的是了解LSTV相关的退行性病变及其与下腰痛(LBP)和神经根痛(RP)的相关性。
方法:使用Pfirrmann评分评估整个脊柱MRI的椎间盘退变,对于使用总端板得分(TEPS)的端板变化,LBP和RP患者的面向性。分析了它们与LSTV的关联。
结果:第1组LSTV见于15%的患者中,其中83%的患者有圣化。58%的椎间盘退变,51%和63%的患者处于C级,B和A,神圣化患者在所有3个级别都有明显的变性。同样,圣化患者的TEPS评分和方面向性明显更高。在31%的人中观察到了方向性,40%和35%的非LSTV,圣化和腰痛患者,分别。第2组LSTV在17%的患者中可见,圣化占82%。44%的椎间盘退变,36%,54%的患者处于C级,分别为B和A。组间TEPS平均评分无显著差异,然而,在89%和81%的圣化和腰痛患者中发现了面向性,相比之下,在非LSTV患者中只有19%。
结论:我们的研究表明,下腰痛患者的骶骨化发生率较高,并伴有相应的椎间盘退变,面向性和EPC。在神经根性疼痛组中,伐木症仅与小面向性有关。这些发现可以帮助临床医生进行预后和患者咨询。
To understand lumbosacral transitional vertebra (LSTV)-associated degenerative pathologies and their correlation to low back pain and radicular pain.
Whole-spine magnetic resonance imaging was evaluated for disc degeneration using Pfirrmann grading, end plate changes using total end plate score (TEPS), and facet tropism in patients with low back pain and radicular pain, and their association with LSTV was analyzed.
In group 1, LSTV was seen in 15% of patients with 83% of these patients having sacralization. Disc degeneration was seen in 58%, 51%, and 63% of patients at levels C, B, and A, respectively; patients with sacralization had significant degeneration at all 3 levels. Similarly, the total end plate score and facet tropism were significantly higher in patients with sacralization. Facet tropism was observed in 31%, 40%, and 35% of patients with no -LSTV, patients with sacralization, and patients with lumbarization, respectively. In group 2, LSTV was seen in 17% of patients with sacralization accounting for 82%. Disc degeneration was seen in 44%, 36%, and 54% patients at levels C, B, and A, respectively. No significant difference was observed in the mean total end plate score between groups. Facet tropism was identified in 89% and 81% of patients with sacralization and patients with lumbarization, respectively, compared with only 19% of patients with no LSTV.
Patients with low back pain had a higher incidence of sacralization with corresponding disc degeneration, facet tropism ,and end plate changes. In patients with radicular pain, lumbarization was associated only with facet tropism. These findings may aid clinicians in prognostication and patient counseling.