模拟棘突椎板侧翻造盖术的CT图像测量

CT measurement on a mimic operation of spinal process and vertebral lamina turnover shelf procedure

中文关键词:  棘突椎板  侧翻  腰椎管狭窄症  手术  ＣＴ

英文关键词:Spinal process and vertebral lamina  Turnover  Lumbar spinal stenosis  Surgery  CT scan

中文摘要:

  【摘要】 目的：通过对模拟棘突椎板侧翻造盖术ＣＴ图像的测量，探讨该术式用于治疗腰椎管狭窄症的可行性。方法：将50例门诊腰痛患者（除外脊柱畸形、腰椎间盘突出症和腰椎管狭窄症者）的腰椎CT图像输入计算机，用Photoshop软件在图像上完成棘突椎板翻转造盖术，测量L3~L5椎板和棘突的高度，“术后”棘突加半侧椎板的长度及椎管面积，并与“术前”椎弓根内缘长度、椎管面积进行比较。结果：棘突高度L3为24.68±2.81mm，L4为22.44±4.33mm，L5为19.46±3.69mm，与原椎板高度比较无显著性差异（P＞0.05）。棘突加半侧椎板长度L3为34.68±3.91mm，L4为35.44±3.43mm，L5为34.56±3.76mm，均大于原椎体的椎弓根内缘长度（P＜0.05）。术后椎管截面积L3为516.01±13.75mm2，L4为507.76±12.85mm2，L5为508.03±12.12mm2，均明显大于术前椎管面积（P＜0.05）。结论：翻转后的棘突椎板可完全覆盖切除的椎板缺损，并可以扩大原来的椎管截面积，可作为治疗腰椎管狭窄症的术式之一。

英文摘要:

  【Abstract】 Objective：To investigate the feasibility and CT measurement of spinal process and vertebral lamina turnover shelf operation for lumbar spinal stenosis.Method：CT images of 50 cases of out-patient with low back pain（excluding spinal deformity，lumbar disc herniation and lumbar spinal stenosis） were transferred into the computer，and spinal process and vertebral lamina turnover shelf operation was performed mimically on computer by using Photoshop software.The height of spinal process and vertebral lamina，the postoperative length of spinal process and a half of vertebral lamina and the area of vertebral canal were measured at L3~L5 level.The preoperative length of inner pedicle margin and the area of vertebral canal on CT scan were measured and compared with the postoperative ones.Result：The height of L3，L4 and L5 spinal process was 24.68±2.81mm，22.44±4.33mm and 19.46±3.69mm respectively，no significant difference was noted between them（P＞0.05）.The length of spinal process and a half of vertebral lamina of L3，L4 and L5 was 34.68±3.91mm，35.44±3.43mm and 34.56±3.76mm respectively，which were more than that of inner pedicle margin（P＜0.05）.The postoperative spinal canal area of L3，L4 and L5 was 516.01±13.75mm２，507.76±12.85mm２ and 508.03±12.12mm２ respectively，which were more than preoperative ones（P＜0.05）.Conclusion：The spinal process vertebral lamina after turnover can cover the defect due to removal of lamina，which can enlarge lumbar canal and can be used as an alternative to conventional laminectomy.