摘要
背景:CT检查能够对椎管诸径线进行测量,对狭窄类型、形态、程度及其与周围组织关系进行分析,对腰椎管狭窄症具有明确诊断的作用。目的:采用一种自行设计的CT图像测量方法,分析腰椎黄韧带变性、肥厚与腰椎管狭窄症的关系。方法:黄韧带组织取材于3组病例:腰椎管狭窄症患者、腰椎间盘突出症患者及腰椎外伤骨折患者。通过切片苏木精-伊红染色观察3组病例黄韧带组织的病理学特点,以腰椎骨折组作为对照。腰椎管狭窄症与腰椎间盘突出症患者均常规进行了CT扫描,通过测量腰椎不同间隙在椎间盘平面以及椎弓上切迹平面关节囊部黄韧带的厚度,以及椎管左右侧的前后斜径,计算二者的比值,分析黄韧带的厚度与腰椎管狭窄症的关系。结果与结论:在腰椎管狭窄症组、腰椎间盘突出症组及腰椎骨折组的CT图像测量中,腰椎管狭窄症组黄韧带厚度平均>(4.79±1.07)mm,黄韧带厚度与椎管前后斜径的比值≥0.41±0.08;腰椎间盘突出症组黄韧带厚度平均>(3.18±0.71)m,黄韧带厚度与椎管前后斜径的比值≥0.26±0.07,两组差异具有显著性意义(P<0.01)。腰椎管狭窄症组黄韧带厚度与椎管前后斜径的比值明显大于腰椎间盘突出症组及腰椎骨折组。提示在腰椎CT横断面上计测黄韧带厚度>4mm,黄韧带厚度与椎管前后斜径的比值≥0.41可能可以作为选择椎管狭窄症手术适应证的指标之一。
BACKGROUND：CT examination can measure spinal canal diameters and analyze stenosis type,appearance,degree,and correlation with surrounding tissues to help diagnose lumbar spinal stenosis （LSS）. OBJECTIVE：To analyze the effect of the degenerative and hypertrophied lumbar ligamentum flavum on LSS by measurement of CT image. METHODS：Ligamentum flavum specimens were obtained from a total of three groups of patients：LSS,lumbar disc herniation （LDH） and spinal fractures. These slices were selected for hematoxylin-eosin staining to observe the pathologic features. The CT scan was used normally in LSS and LDH groups. The thickness of the capsular portion of the ligament and the front-back oblique diameter of lumbar canal were measured in different lumbar interspace. Intervertebral disc plane and vertebral arch superior thyroid notch plane were selected for measuring the two data. The thickness of ligamentum flavum and its relationship to LSS were analyzed by computing the ratio of the thickness to the front-back oblique diameter of lumbar canal. RESULTS AND CONCLUSION：The mean thickness of ligamentum flavum was greater than （4.79±1.07） mm,and ratio of ligamentum flavum thickness to the front-back oblique diameter of lumbar canal was greater than 0.41±0.08 in LSS group,and （3.18±0.71） mm,and 0.26±0.07 in LDH group. The difference between LSS and LDH was statistically significant （P 0.01）. The ratio of ligamentum flavum thickness to the front-back oblique diameter of lumbar canal was significantly greater in LSS group compared with LDH and spinal fracture groups. Results demonstrated that the measurement of thickness of ligamentum flavum （ 4 mm） and ratio of ligamentum flavum thickness to the front-back oblique diameter of lumbar canal ≥0.41 may function as one of indexes of choosing LSS operable indication.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第52期9756-9759,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
