目的 探讨椎间盘退变与腰椎节段稳定性失衡之间的定量关系,并分析不同基线特征(如年龄、BMI)对二者关系的影响。方法 回顾性纳入200例椎间盘退变患者,通过影像学检查(MRI、X线、CT)和功能评估量表(ODI、RMDQ)对椎间盘退变及腰椎稳定性进行分析。使用单因素方差分析和多元线性回归模型评估基线特征对腰椎功能的影响。结果 椎间盘退变程度与腰椎节段稳定性失衡显著相关(P＜0.01)。随着Pfirrmann分级升高,腰椎活动度由Ⅰ级的(52.3°±5.7°)逐渐下降至Ⅴ级的(22.6°±3.9°),ODI评分由(10.2±2.1)升高至(29.3±4.1),RMDQ评分由(4.8±1.4)升高至(16.4±2.7)。Logistic回归分析显示,椎间盘退变程度(OR=1.51, 95%CI: 1.28~1.78)、关节突退变(OR=1.32, 95%CI: 1.05~1.67)及BMI(OR=1.14, 95%CI: 1.01~1.29)是稳定性失衡的独立危险因素。结论 椎间盘退变与腰椎节段稳定性失衡之间存在显著的定量关联,且基线特征(如年龄、BMI)对二者关系有重要影响,临床应根据患者个体特征制定针对性的预防和治疗策略。

Objective To quantitatively investigate the relationship between the intervertebral disc degeneration and the imbalance of lumbar segmental stability, and to analyze the influence of various baseline characteristics (such as age and BMI) on this relationship. Methods A retrospective study of 200 patients with intervertebral disc degeneration was conducted. The intervertebral disc degeneration and lumbar stability were evaluated using imaging examinations (MRI, Xray, CT) and functional assessment scales (ODI, RMDQ). Univariate analysis of variance and multiple linear regression models were employed to assess the influence of baseline characteristics on lumbar function. Results A significant correlation was observed between the degree of disc degeneration and lumbar segmental stability imbalance (P<0.01). As the Pfirrmann grade increased from I to V, lumbar range of motion decreased from (52.3°±5.7°) to (22.6°±3.9°), ODI score increased from (10.2±2.1) to (29.3±4.1), and RMDQ score rose from (4.8±1.4) to (16.4±2.7). Logistic regression analysis showed that the degree of intervertebral disc degeneration (OR=1.51, 95% CI: 1.28-1.78), facet joint degeneration (OR=1.32, 95% CI: 1.05-1.67), and BMI (OR=1.14, 95% CI: 1.01-1.29) were independent risk factors for stability imbalance. Conclusions Intervertebral disc degeneration is significantly and quantitatively associated with lumbar segmental stability imbalance, and baseline characteristics such as age and BMI critically influence this relationship. Clinical strategy should therefore be tailored to patientspecific factors for prevention and treatment.