Relationship between Degenerative Lumbar Spondylolisthesis and Facet Joint Angles and Zygapophyseal Articular Process Root Angles Based on CT Observation
Objective:To explore the relationship between degenerative lumbar spondylolisthesis(DLS)and facet joint angles and zygapophyseal articular process root angles based on CT observation.Methods:A retrospective analysis was conducted on 169 patients diagnosed with DLS at Sichuan Provincial Orthopedic Hospital from January 2020 to June 2022(DLS group).Additionally,169 age-matched patients with lumbar and leg pain but without lumbar spondylolisthesis,who underwent physical examinations during the same peri-od,were selected as the healthy control group.Clinical data were compared between the two groups,and both univariate and multivariate logistic regression analyses were performed to identify factors influencing DLS.Smooth curve fitting was used to analyze the curve relationship between facet joint angles,zygapophyseal artic-ular process root angles,and DLS.A Bayesian network model was constructed,and its predictive performance was validated.Results:Univariate analysis revealed that BMI,intervertebral disc degeneration,systemic joint laxity,changes in lumbar spine structure and curvature,ligament laxity,osteoporosis,decalcification,lumbar facet joint lesions,and comorbid diabetes were higher in the DLS group than in the healthy group(P<0.05).The facet joint angles in the DLS group were smaller than those in the healthy group,and the proportion of in-dividuals with asymmetrical facet joint angles and degeneration degrees of 1 and 2 increased,while the zyg-apophyseal articular process root angle significantly increased(P<0.05).Multivariate analysis indicated that an increase in BMI,intervertebral disc degeneration,changes in lumbar spine structure and curvature,liga-ment laxity,osteoporosis,decalcification,systemic joint laxity,lumbar facet joint lesions,comorbid diabetes,decrease in facet joint angles,asymmetry of facet joint angles,degeneration of facet joint angles,and an in-crease in zygapophyseal articular process root angles were all risk factors for DLS(OR>1,P<0.05).Smooth curve fitting results demonstrated a positive correlation between zygapophyseal articular process root angles and DLS within a certain range,while facet joint angles showed a negative correlation with DLS.The Bayesian net-work model and predictive reasoning revealed that an increase in BMI,decrease in facet joint angles,asymme-try of facet joint angles,and an increase in zygapophyseal articular process root angles were directly associated with DLS.When the probability of decreased facet joint angles,asymmetry of facet joint angles,and an in-crease in zygapophyseal articular process root angles reached zero,the occurrence rate of DLS decreased from 50%to 37.2%.Model validation confirmed the good discriminability,accuracy,and effectiveness of the Bayesian network predictive model.Conclusion:CT observation provides a more accurate diagnosis of DLS,and within a certain range,facet joint angles and zygapophyseal articular process root angles are correlated with DLS.
Degenerative lumbar spondylolisthesisComputer tomographyAngles of zygapophy-sial jointsPedicle facet angleCorrelationBayesian network model
万方数据
维普
