关键词: 慢性非特异性腰痛, X线片, 腰椎侧弯, 棘突偏歪, 椎体滑脱

Abstract: Objective To study the lumbar scoliosis,L1-5 spinous process deviation and spondylolisthesis in spine X-ray of patients with chronic non-specific low back pain（CNLBP）,and summarizing the existing rules,so as to provide imaging theoretical support for the treatment of CNLBP．Methods A total of 164 patients with CNLBP were selected．The lumbar scoliosis,L1-5 spinous process deviation and spondylolisthesis were observed and recorded in the anteroposterior and lateral X-ray films of each patient．The lumbar scoliosis,spinous process deviation and spondylolisthesis were statistically analyzed by statistical software．Results A total of 59 people had lumbar scoliosis,accounting for 35.98%．There were 47 patients with 5°-10°Cobb angle,accounting for 28.66%．There were 12 patients with Cobb angle >10°,accounting for 7.32%．L4 was the main lower apical vertebra of lumbar scoliosis．There were 12 patients with L3 as the lower apical vertebra,accounting for 20.34%;37 patients with L4 as the lower apical vertebra,accounting for 62.71%;10 patients with L5 as the lower apical vertebra,accounting for 16.95%．A total of 119 people appeared spinous process deviation,accounting for 72.56%．L5 spinous process deviation was the most common,with proportion of 57.93%,and L4 was the second,with proportion of 48.17%．The results of chi-square test showed that there were significant differences between L5 and L1-L3 spinous process deviation（χ² were 14.580,11.771,7.484,and P values were <0.001,0.001,0.006 respectively）,but no significant difference between L5 and L4 spinous process（χ²=3.124,P=0.077）．A total of 30 patients had spondylolisthesis,accounting for 18.29%．L5 was the most common of spondylolisthesis,with an occurrence rate of 8.54%．L4 was the second,with an occurrence rate of 7.93%．There was no significant difference in spondylolisthesis rate between L4 and L5（χ²=0.040,P=0.841）．The spondylolisthesis rates of L4 and L5 were significantly different from those of L1,L2 and L3（L5 and L1,L2,L3：χ² were 14.580,11.771,7.484,and P values were <0.001,0.001,0.006 respectively;L4 and L1,L2,L3：χ² was 13.495,10.712,6.550,P values was <0.001,0.001,0.010 respectively）．Conclusions Lumbar scoliosis is more common in patients with CNLBP,and L4 is the main lower apical vertebra of lumbar scoliosis．Patients with CNLBP often have spinous process deviation,and the most common is L5 spinous process deviation,followed by L4．L5 and L4 are the most common vertebrae with spondylolisthesis in patients with CNLBP．The soft injury and joint degeneration or disorder related to L5 and L4 should be paid more attention in the treatment of patients with CNLBP．

Key words: chronic non-specific low back pain, X-ray, lumbar scoliosis, the deviation of spinous process, spondylolisthesis