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目的 为了解井下矿工腰脊柱退行性变情况 ,探讨下背痛的原因。方法 选择 40名有下背痛史、年龄 30～ 5 0岁、工龄 10～ 30年的井下矿工作为观察组 ;同时选择年龄、工龄和身高等相近的井上体力劳动者作为对照组 ;用GEProspeedAI型CT机对两组人群腰 (骶 )椎间盘 (L3/L4、L4/L5、L5 /S1)进行扫描 ,比较两组椎间盘突出、椎管矢状径大小、侧隐窝高度、椎体骨质增生、韧带肥厚等。结果 观察组L3/L4、L4/L5、L5 /S1椎间盘突出 (0 .33± 0 .15、0 .5 3± 0 .2 5、0 .45± 0 .18)较对照组 (0 .2 8± 0 .11、0 .32± 0 .2 1、0 .37± 0 .19)明显 ;侧隐窝高度 (0 .40± 0 .0 8、0 .31± 0 .0 5、0 .37± 0 .0 7)比对照组 (0 .42± 0 .10、0 .43± 0 .0 7、0 .40± 0 .0 6 )窄 ,但仅L4/L5水平差异有显著性 (P <0 .0 1) ;椎管矢状径大小比对照组窄 ,但差异无显著性 (P >0 .0 5 ) ;椎体骨质增生 (4 5 .0 0 %)、韧带肥厚 (4 2 .5 0 %)及钙化 (2 2 .5 0 %)比对照组 (2 3.33%、16 .6 7%、16 .6 7%)多见 ,但两组间仅韧带肥厚发生率的差异有显著性 (P <0 .0 5 )。结论 井下矿工腰脊柱退行性变比对照组严重 ,主要表现为L4/L5椎间盘突出和侧隐窝变窄。
Objective To understand the miners lumbar spine degeneration, investigate the causes of lower back pain. Methods Forty downhole miners with history of lower back pain, 30-50 years of age and 10-30 years of service were selected as the observation group. At the same time, uphole workers with similar working age and seniority were selected as the control group. The CT scanners were used to scan the lumbosacral (L3 / L4, L4 / L5, L5 / S1) discs of the two groups. The intervertebral disc herniation, spinal canal sagittal diameter, lateral recess height, , Ligament hypertrophy and so on. Results Compared with the control group, the L3 / L4, L4 / L5 and L5 / S1 disc herniation in the observation group (0.33 ± 0.15,0.53 ± 0.25,0.45 ± 0.18) 8 ± 0 .11,0 .32 ± 0 .2 1,0 .37 ± 0 .19) were significant; lateral recess height (0 .40 ± 0 .0 8,0 .31 ± 0 .0 5,0. 37 ± 0.07) was narrower than that of the control group (0.42 ± 0.10,0.43 ± 0.07,0.40 ± 0.06), but only the L4 / L5 level was significantly different ( P <0.01). The sagittal diameter of spinal canal was narrower than that of the control group, but the difference was not significant (P> 0.05); vertebral hyperostosis (45.0%), ligamentous hypertrophy 4 2 .50%) and calcification (22.5%) than the control group (2.33%, 16.67%, 16.67%) more common, but only between the two groups the incidence of ligamentous hypertrophy The difference was significant (P <0.05). Conclusions The miners’ lumbar and spine degenerative changes are more serious than those in the control group, mainly showing L4 / L5 disc herniation and lateral recess narrowing.