摘要
目的探索不同负重状态下直立位腰椎L_(3)、L_(4)椎体屈伸运动过程中体运动轨迹,分析负重状态下腰椎在体运动的规律和特点。方法招募2018年8月至2020年8月10名无症状的青年志愿者,使用双荧光透视系统DFIS与CT相匹配技术,经平扫CT获取L_(3)~S_(1)的图像进行三维重建。于放射线透视不同负重下0、5、10 kg完成下腰椎的前屈到直立到后伸动作获得X线影像,通过轮廓重叠实现二维到三维图像的匹配,还原下腰椎椎体的三维运动轨迹。结果下腰椎在前屈到站立位时:不同负重下腰椎椎体0、5、10 kg的X轴的运动位移分别为-1.05(-2.42,1.72)、0.63(0.15,4.26)、-0.39(-0.75,3.12)mm。X轴运动位移比较5 kg>10 kg>0 kg,差异有统计学意义(P<0.05)。γ角度分别为-0.26(-1.30,5.43)、0.93(0.24,5.42)、-0.95(-2.12,4.32)°。γ角度比较5 kg>0 kg>10 kg,差异有统计学意义(P<0.05)。下腰椎在站立到后伸位时:不同负重下腰椎椎体0、5、10 kg X轴的运动位移分别为0.90(-0.82,3.74)、-0.91(-1.55,4.26)、0.07(-0.92,3.25)mm。Z轴的运动位移分别为-0.25(-0.54,1.78)、0.40(-0.68,2.37)、-0.19(-0.92,1.03)mm。X轴运动位移比较0 kg>10 kg>5 kg,Z轴运动位移比较5 kg>10 kg>0 kg,差异有统计学意义(P<0.05)。α角度分别为0.91(-0.82,2.85)、-0.61(-0.14,3.79)、0.54(-0.82,3.87)°。γ角度分别为1.15(0.24,5.32)、0.92(-0.67,5.45)、0.65(-1.24,5.32)°。α角度比较0 kg>10 kg>5 kg,γ角度比较0 kg>5 kg>10 kg,差异有统计学意义(P<0.05)。结论负重5 kg下腰椎椎体在体运动的位移和旋转角度和0 kg相比差异有统计学意义,可能与腰椎退行性疾病有一定关联。下腰椎退行性疾病可能与X轴位移的关系更为密切。
Objective To explore the trajectory of body motion during flexion and extension of L_(3) and L_(4) vertebrae in an upright position under different loads,and to analyze the laws and characteristics of in vivo motion of lumbar vertebrae under loads.Methods From August 2018 to August 2020,10 asymptomatic young volunteers were recruited,and the images of L_(3)-S_(1) were obtained by plain CT using the matching technology of dual fluoroscopy system DFIS and CT for three-dimensional reconstruction.X-ray images were obtained by performing flexion-upright-extension motions of the lower lumbar spine under different loads of 0,5 and 10 kg in radiographic perspective,and two-dimensional to three-dimensional images were matched through contour overlapping to restore the three-dimensional motion trajectory of the lower lumbar vertebral body.Results When the lower lumbar vertebrae are bent forward to a standing position,the X-axis displacement of the lumbar vertebrae at 0,5,and 10 kg under different loads is-1.05(-2.42,1.72),0.63(0.15,4.26),-0.39(-0.75,3.12)mm,and the X-axis displacement is 5 kg>10 kg>0 kg,with statistical significance difference(P<0.05).Theγangles are-0.26(-1.30,5.43),0.93(0.24,5.42),and-0.95(-2.12,4.32)°,respectively.The difference inγangle was statistically significant(P<0.05),when compared to 5 kg>0 kg>10 kg.When the lower lumbar vertebrae stand to the extended position,the X-axis displacement of the lumbar vertebrae at 0,5,and 10 kg under different loads is 0.90(-0.82,3.74),-0.91(-1.55,4.26),and 0.07(-0.92,3.25)mm,respectively.The movement displacement of the Z-axis is-0.25(-0.54,1.78),0.40(-0.68,2.37),and-0.19(-0.92,1.03)mm,respectively.The X displacement comparison showed a statistically significant difference of 0 kg>10 kg>5 kg,while the Z displacement comparison showed a difference of 5 kg>10 kg>0kg(P<0.05).Theαangles are 0.91(-0.82,2.85),-0.61(-0.14,3.79),and 0.54(-0.82,3.87)degrees,respectively.Theγangles are 1.15(0.24,5.32),0.92(-0.67,5.45),and 0.65(-1.24,5.32)degrees,respectively.Theαangle comparison showed a statistically significant difference between 0 kg>10 kg>5 kg,and theγangle comparison showed a difference of 0 kg>5 kg>10 kg(P<0.05).Conclusion There are statistical differences in the in vivo motion displacement and rotation angle between lumbar vertebral bodies under loads of 5 kg and 0 kg,which may be related to lumbar degenerative diseases.Degenerative diseases of lower lumbar spine may be more closely related to X-axis displacement.
作者
宋阳
苗军
冷辉
张海军
赵磊
赵雪晴
SONG Yang;MIAO Jun;LENG Hui;ZHANG Haijun;ZHAO Lei;ZHAO Xueqing(DepartmentⅡof Orthopedics,Chifeng Municipal Hospital,Inner Mongolia,Chifeng 024000,China;DepartmentⅡof Spine,Tianjin Hospital,Tianjin 300211,China;Department of Spinal Surgery,Chifeng Municipal Hospital,Inner Mongolia,Chifeng 024000,China;Department of Neurology,Chifeng Municipal Hospital,Inner Mongolia,Chifeng 024000,China)
出处
《中国医药科学》
2024年第10期170-174,共5页
China Medicine And Pharmacy
基金
内蒙古医科大学联合项目(YKD2022LH048)。
关键词
腰椎
在体运动
六个自由度
负重
退行性疾病
Lumbar vertebrae
In vivo motion
Six degrees of freedom
Load
Degenerative disease