不同体位X线片上腰椎间孔的变化及在经皮椎间孔镜手术中的意义

Morphologic changes of lumbar foramen on X-rays in different positions and the relation with percutaneous endoscopic surgery

中文关键词:  腰椎间孔  X线  椎间孔镜手术

英文关键词:Lumbar foramen  X-rays  Endoscopic surgery

中文摘要:

  【摘要】 目的：测量腰椎间孔在中立、过伸和过屈侧位X线片上的变化，探讨不同体位下椎间孔的变化以及在经皮椎间孔镜手术中的意义。方法：选取2014年12月～2015年10月因腰腿痛来我院行腰椎X线检查的患者100例，其中男性58例，女性42例；在每位患者腰椎中立、过伸和过屈侧位X线片上测量各腰椎间孔的高度、宽度和腰椎前凸角度，并根据腰椎活动度（中立位-过屈位腰椎前凸角）进行分组（＜10°、10°～20°及＞20°组）统计。采用单因素方差分析和Pearson相关分析，比较各椎间孔测量参数在不同体位时的变化，以及各椎间孔高度和宽度的变化与不同腰椎活动度的关系。结果：中立位时，腰椎间孔平均高度为20.2±3.7mm（15.0～22.7mm），宽度为13.7±2.7mm（6.7～10.8mm），自上而下各腰椎间孔高度和宽度呈降低趋势。过伸位时各腰椎间孔高度、宽度较中立位减少，但无显著性差异（P>0.05），过屈位时各腰椎间孔高度、宽度较中立位和过伸位增加，并有显著性差异（P<0.05）。与腰椎活动度<10°和10°~20°两组相比，在腰椎活动度>20°组内，L1～L5节段椎间孔高度及L2～L5节段椎间孔宽度显著增加，且有统计学差异（P<0.05）。结论：屈曲位时腰椎间孔高度和宽度较中立及过伸位时明显增加，而且椎间孔高度及宽度随着腰椎前屈角度增加而增大。

英文摘要:

  【Abstract】 Objectives: To measure and analyze lumbar foramen parameters on X-rays in natural, extension and flexion positions, and to illustrate the changes of foramen in different positions and its relation with endoscopic surgery. Methods: From December 2014 to October 2015, 100 patients(58 males and 42 females) suffering from low back pain who performed X-ray in our hospital were selected. The height, width of lumbar foramen and the lumbar lordosis were measured on each X-ray in neutral, flexion and extension positions. Based on the lumbar motion changes from neutral to flexion, the patients were diveded into 3 groups(＜10°, 10°-20° and ＞20°). The differences in foramen and vertebrae parameters among positons were analyzed by using one-way ANOVA, Pearson′s correlation coefficients were used to investigate the changes of foramen height and width in different postions and the relationship between these changes and lumbar motion. Results: The average height of lumbar foramen was 20.2±3.7mm(15.0-22.7mm) and the width was 13.7±2.7mm(6.7-10.8mm) in neutral position. The height and width of intervertebral foramen decreased from top to bottom segment of lumbar spine. All lumbar foramen heights and widths decreased in extension compared to neutral position, but there was no statistical significance(P>0.05). The height and width of lumbar foramen in flexion increased significantly compared to neutral and extension positions(P<0.05). In the group of lumbar flexion >20°, foramen heights at all segments except L5/S1 and foramen widths from L2-L5 increased significantly compared to the groups of <10° and 10°-20°(P<0.05). Conclusions: Lumbar foramen heights and widths increase significantly in flexion positions, and widths increase subsequent to the flexion angle increase.