基于磁共振扫描的腰椎滑脱症患者小关节积液及椎间盘关节特征与意义的研究OA

[Objective]To explore the lumbar parameters and the characteristics of facet joint effusion in patients with degenerative lumbar spondylolisthesis(DLS)under magnetic resonance imaging(MRI)scans,and based on this,construct a risk factor model for the occurrence of DLS in patients with lumbar degenerative diseases,and analyze the predictive value.[Methods]A total of 70 patients diagnosed with DLS in Kaifeng Traditional Chinese Medicine Hospital between April 2021 and December 2024 were selected as the DLS group,while another 70 patients with lumbar degenerative disease but without lumbar spondylolisthesis were enrolled as the control group.All participants in both groups had complete MRI examination parameters.Statistical analyses were performed on sagittal and axial MRI parameters,as well as on the cross-sectional area of the lumbar paraspinal muscles and the width of facet joint effusion.A logistic regression model was constructed,and a receiver operating characteristic(ROC)curve was plotted to conduct predictive analysis.[Results]In the DLS group,68.57%of patients had intervertebral disc degeneration>grade III,65.71%had facet joint degeneration>grade II,78.57%exhibited Modic type III endplate changes,and 54.29%showed multifidus muscle fat infiltration reaching grade III.These proportions were significantly higher than those in the control group(35.71%,32.86%,28.57%,and 32.86%,respectively),and all differences were statistically significant(P<0.05).The cross-sectional areas of the left and right multifidus muscles in the DLS group were significantly smaller than those in the control group,with all differences being statistically significant(P<0.05).Sagittal lumbosacral angle and the measured width of facet joint effusion were significantly greater in the DLS group than in the control group,and these differences were also statistically significant(P<0.05).No statistically significant differences were observed between the two groups in the cross-sectional areas of the left and right psoas major muscles,the left and right erector spinae muscles,or the thickness of the ligamentum flavum(P>0.05).Results from the logistic regression model indicated that intervertebral disc degeneration>grade III,facet joint degeneration>grade II,Modic type III endplate changes,smaller cross-sectional area of the left and right multifidus muscles,larger lumbosacral angle,and greater facet joint effusion were risk factors for the occurrence of DLS in patients with lumbar degenerative disease(P<0.05).The logistic regression model yielded a sensitivity of 81.73%and a specificity of 78.66%for predicting DLS in patients with lumbar degenerative disease;the area under the ROC curve(AUC)was 0.868[95%confidence interval(CI):0.814-0.923].[Conclusion]The sagittal and axial parameters of the lumbar vertebrae in patients with lumbar degenerative diseases under MRI scans have undergone significant changes.Moreover,the effusion of facet joints is significant and the multifidus muscle has degeneration,all of which are closely related to the occurrence of DLS.Constructing a model based on the above parameters for the prediction of DLS has high clinical value.