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目的:分析青少年腰椎间盘突出症(ALDH)与腰骶部发育异常的关系。方法:选取2011年1月至2016年6月在本院就诊的ALDH患者52例作为ALDH组,按照1∶1配对原则,选取同期无症状青少年52例作为对照组。采用回顾性分析,统计腰骶部移行椎的发生率及Castellvi分型等。结果:ALDH组的腰骶部移行椎发生率明显高于对照组(P<0.05)。在ALDH患者中,腰骶部移行椎患者和无腰骶部移行椎患者在L_(3~4),L_(4~5)及L_5S_1节段的发生率差异无统计学意义(P>0.05);Ⅰb型腰骶部移行椎的L_(4~5)节段多于L_5S_1节段(P<0.05),Ⅲb型腰骶部移行椎的L_5S_1节段多于L_(4~5)节段(P<0.05),其它型L_(4~5)和L_5S_1节段的ALDH发生率比较差异均无统计学意义(P>0.05)。结论:ALDH并发腰骶部移行椎的发生率高于正常青少年,其中Ⅰb型腰骶部移行椎易致L_(4~5)节段椎间盘突出,Ⅲb型腰骶部移行椎易致L_5S_1节段椎间盘突出。
Objective: To analyze the relationship between lumbosacral dysplasia and lumbar disc herniation (ALDH) in adolescents. Methods: From January 2011 to June 2016, 52 patients with ALDH in our hospital were selected as the ALDH group. According to the principle of 1: 1 matching, 52 asymptomatic adolescents in the same period were selected as the control group. Using retrospective analysis, the incidence of lumbosacral transitional vertebrae and Castellvi classification. Results: The incidence of lumbosacral transitional vertebrae in ALDH group was significantly higher than that in control group (P <0.05). In patients with ALDH, the incidence of L_ (3 ~ 4), L_ (4 ~ 5) and L_5S_1 segments in patients with lumbosacral metastases and those without lumbosacral metastases was not significantly different (P> 0.05) ; L4 (4 ~ 5) segments of lumbosacral transition type Ⅰb were more than L5S_1 segments (P0.05); Ⅰ_3L lumbosacral transitional L5S_1 segments were more than L_ (4 ~ 5) segments P <0.05). There was no significant difference in the incidence of ALDH among other types of L_ (4 ~ 5) and L_5S_1 (P> 0.05). CONCLUSIONS: The incidence of lumbosacral transitional vertebrae in ALDH is higher than that in normal adolescents. The type Ⅰb lumbosacral transitional vertebra leads to the disc herniation of L_ (4 ~ 5) segments. The type Ⅲb lumbosacral transitional vertebra leads to the L_5S_1 segment Disc herniation.