요추부 퇴행성 변화와 척추후관절 운동성과의 관계
The Change of Lumbar Facet Joint Motility in the Degenerative Process
소속 상세정보
박승원/Seung Won Park
권정택/김영백/민병국/황성남/최덕영/석종식/Jeong Taik Kwon/Young Baeg Kim/Byung Kook Min/Hwang Nam Hwang/Duck Young Choi/Jong Sik Suk
KMID : 0359819970260010011
Abstract
결 론
각 연령대별 단순 요부염좌 환자와 퇴행성 척추 불안정 환자에서 측정한 요추부 굴신전
운동에 따른 추간공의 면적 변화를 이용하여 퇴행성 변화와 척추후관절의 운동성과의 관계
를 조사하였으며 다음과 같은 결과를 얻을 수 있었다
1) 요추부 굴신전 운동중 굴전시의 추간공 면적이 신전시의 면적보다 넓었으며 이때의 면
적증가는 주로 하부 요추체 상관절돌기의 후하방 전위때문이었고 이는 관절의 운동성과 관
련이 있었다.
2) 퇴행성 척추나 경도의 뇌행성 척추 불안정시 굴신전 운동에 따른 추간공 면적의 변화
(특히 굴전시 면적의 증가 정도)가 현저히 감소되는 이유는 척추후관절의 운동성 감소때문
인 것으로 보인다. 이러한 현상은 연령에 의한 자연적인 퇴행성 변화시 제 4∼5 요추간에서
현저하였고 경도의 퇴행성 척추 불안정 환자에서는 제 3∼4번 요추간과 제 4∼5 요추간에서
현저하였다.
결론적으로 요추부의 퇴행성 척추나 초기의 척추 불안정 상태에서는 척추후관절에 불안정
성보다는 오히려 경직성 변화가 먼저 발생하는 것으로 보인다.
#초록#
The areas of lumbar intervertebral foramina(IVF) were measured from flexion and
extension lateral plain films to study the facet joint motility in the degenerative process
of lumbar spine. By studying the facet joint motility, the authors tried to determine
whether the aging or degenerative process would make the facet joints slack or stiff.
This study involved 10 patients with radiographic instability with or without grade Ⅰ
spondylolisthesis at L4-5 who had underwent fusion operation, and 45 patients with only
transient low back pain with normal radiographic finding. The patients with low back
pain only were divided into groups I-Ⅴ according to their ages. Those with spinal
instability was grouped as Ⅵ. The areas(㎟) of IVF at flexion and extension and the
changes of IVF areas(IVF area at flexion-IVF area at extension)IVF area at flexion)
were measured at L1-2, L2-3, L3-4, and L4-5 levels by using image analysing
program(Optimas 5.2R). The IVF areas were significantly narrow at
extension than flexion(p<0.01). The major factors affecting the IVF areas at flexion or
extension were the posteroinferior or anterosuperior displacement of superior articular
process of the inferior vertebral body, respectively. The changes of IVF areas with
motions were greatest at the L4-5 and least at the L1-2 level. In group V(over 50
years of age), the areas at IVF at flexion and the changes of the area with flexion and
extension were significantly decreased at the L4-5 level compared with younger age
group(P,0.05). In group Ⅵ, the area of IVF at flexion and the changes of the area were
significantly decreased at L3-4 and L4-5 levels compared with the other
groups(p<0.001). As a result, we conclude that the changes of IVF area decrease with
aging and degenerative process resulting in facet join stiffening.
키워드
Degeneration; Flexion; Extension; Changes of IVF area; Facet joint motility; Stiffening;
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